A woman in her 60s underwent lower gastrointestinal endoscopy for positive fecal occult blood testing. A circumferential laterally spreading tumor (LST) was found from the rectum to the sigmoid colon, and endoscopic submucosal dissection (ESD) was performed. Pathology confirmed a 160×95 mm intramucosal carcinoma with curative resection, and the patient was discharged on postoperative day 5. To prevent stricture, a local steroid injection was administered the day after ESD. At 2 and 6 weeks post-ESD, the patient was asymptomatic. However, at 12 weeks, defecation difficulty occurred, and endoscopy revealed a stricture. Balloon dilation relieved symptoms, but recurrence at 15 weeks required a second dilation. The patient has since remained asymptomatic. This case illustrates stricture formation after circumferential rectal ESD despite steroid use, raising questions about the efficacy of steroid injections in preventing scarring.
