This therapy should performed for recurrent ulceration in cases of simple ulcer and intestinal Behçet's disease.

Thirty bleeding cases after therapeutic endoscopy for 2916 colorectal lesions were analyzed. The therapeutic endoscopy method, size of lesions, anatomic location, latency between endoscopic therapy and rectal bleeding were recorded for each case. The bleeding rate by hot biopsy was 0.4% (5 lesions), by polypectomy 1.4% (20 lesions) and by endoscopic mucosal resection 1.7% (5 lesions). The bleeding rate was associated with the size of the colorectal polyp. Sessile lesions on the cecum and ascending colon had the highest incidence of bleeding after therapeutic endoscopy. Pedunculated lesions bled more than any other lesions in the rectosigmoid region. A 93% bleeding rate was recognized within the ninth day after therapeutic endoscopy. Endoscopic clipping was the most effective for bleeding after endoscopic resection. None of our cases underwent surgical operation for bleeding after endoscopic resection. Based on these results, we would perform endoscopic clipping to prevent bleeding after removal of any lesion more than 1.0cm in size, such as a sessile lesion on the cecum and ascending colon, or a pedunculated lesion on the rectosigmoid region.

A 53‐year‐old man was referred to our hospital because of the appearance of a positive fecal occult immunological reaction. We found a domed lesion 0.4 cm in diameter in the sigmoid colon. Bleeding spots were observed on the surface of the lesion on endoscopy. We performed endoscopic mucosal resection of the lesion, which was found to contain well‐differentiated adeno‐carcinoma and cancer cells infiltrating to the cut‐end of resected specimen. Laparoscopy‐assisted sigmoidectomy was then performed with dissection of the lymph nodes. The dissected lesion was diagnosed as adenocarcinoma with moderate fibrosis and massive cancerous involvement. The patient died of recurrent cancer 3 years after the operation. In the minute sessile lesion, bleeding spots on the surface may suggest invasive cancer with massive cancer involvement within the submucosal layer.

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