Efficacy of ecabet sodium enema on intractable rectal ulcer after piecemeal endoscopic mucosal resection for rectal tumor.

We describe a case with rectal bleeding from a rectal ulcer after endoscopic mucosal resection (EMR), successfully treated with an ecabet sodium (ES) enema. A 44-year-old woman with a laterally spreading rectal tumor of a granular type, 60 mm in diameter, underwent piecemeal EMR. After the EMR, she suffered from rectal bleeding on several occasions over a period of 1 month. Although she was repeatedly treated with thermocoagulation by a heater probe to stop the bleeding, a rectal ulcer with visible vessels still remained at the resected site. Because the rectal ulcer was considered to be intractable, an ES enema was used twice a day (1.5 g) for 2 weeks, which improved rectal bleeding. Colonoscopic findings revealed that the ulcer improved with mucosal healing after the ES enema treatment. This represents the first report of an ES enema treatment in a patient with a rectal ulcer after EMR. Further studies are needed to determine the effectiveness and safety of using an ES enema in patients with EMR-related refractory colorectal ulcers.