Figure 38.

Endoscopic image of a 12 mm appendiceal adenoma with high-grade dysplastic features (a). On gentle manipulation of the ensnared lesion, the polyp is found to be pedunculated (b). In order to position the snare at the polyp stalk, the endoscopic catheter is gently advanced into the orifice before closing the snare. In order to achieve hemostasis for mild oozing, a semiopened endoclip is advanced into the orifice and applied at the base (c). On pathological examination of the resected polyp, there was focal high-grade dysplasia but the resection was considered curative.