2008 Volume 50 Issue 6 Pages 1461-1465
A 53-year-old woman who refuses blood transfusion based upon her religious belief was referred to our institution. She had 40 mm of a laterally spreading tumor in the transverse colon. Under no sedation, colonoscopy was performed in the Endoscopy Unit . On both plain and magnification chromocolonoscopy, there were no findings suggesting a substantial invasion into the submucosal layer. Endoscopic mucosal resection was selected as an initial treatment . At the first cutting with snaring, spurting bleeding from the thin vessel occurred and then was successfully stopped by endoscopic clipping . Endoscopic resection was continued for the remaining lesion and finally the whole lesion was resected at piecemeal fashion . Absence of recurrent lesion was confirmed by repeat colonoscopies . This paper discussed therapeutic procedure and the management of a large colorectal tumor developing in the patients who refuses blood transfusion based upon their religious belief.
