TY - JOUR T1 - Caecal surprise JF - Frontline Gastroenterology JO - Frontline Gastroenterol DO - 10.1136/flgastro-2022-102327 SP - flgastro-2022-102327 AU - Umang Rafiq Qazi AU - Thomas P Chapman AU - Peter John Basford Y1 - 2023/03/17 UR - http://fg.bmj.com/content/early/2023/03/16/flgastro-2022-102327.abstract N2 - A 67-year-old man was referred urgently by his primary care practitioner with rectal bleeding. The patient reported a single episode of dark red blood per rectum, without associated abdominal pain, change in bowel habit or weight loss. He had a background of a congenital bicuspid aortic valve, and prostate cancer treated with prior radiotherapy and ongoing hormonal therapy. He was on aspirin but no other anticoagulation. Physical examination of the abdomen and rectum was unremarkable. Haemoglobin was within the normal range (13.7 g/dL).To further investigate the rectal bleeding, he underwent colonoscopy which demonstrated a 10 cm polypoid lesion with tip ulceration arising from the cecum in the region of the ileocaecal valve (figure 1). Biopsies were taken.Figure 1 Endoscopic view of polypoid mass arising from ileocaecal valve.How would you further investigate and what is the most likely diagnosis?Intussusception … ER -