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Sarkar et al (Gut 2009;58:33) recently reported an unfortunate clinical case of delayed caecal perforation following a submucosal injection for an aborted endoscopic mucosal resection (EMR) of a 15 mm sessile polyp. This complication has not been described in a number of large series of colonic EMR.1–3 The authors mentioned a possible harmful role of methylene blue but we have used this solution in very low concentration for the past 12 years for colonic EMR (>1000 cases) …
Competing interests: None.
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