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‘Fish-eye’ polypectomy defect: a new sign during endoscopic mucosal resection?
  1. Sergei Vosko1,
  2. Neal Shahidi1,2,3,
  3. Sunil Gupta1,3,
  4. W Arnout van Hattem1,
  5. Michael J Bourke1,3
  1. 1 Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3 Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Michael J Bourke, Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW 2145, Australia; michael{at}

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A 75-year-old man was referred for the endoscopic management of an 80 mm large non-pedunculated colorectal polyp (LNPCP) in the sigmoid colon.

The lesion was evaluated under white-light (figure 1A), narrow-band imaging and near-focus. Granular nodular-mixed type morphology was identified with a homogeneous surface pattern (Kudo IV, Japan NBI Expert Team IIA) consistent with benign adenomatous histopathology.

Figure 1

80mm large non-pedunculated colorectal polyp (LNPCP) in the sigmoid colon.

Piecemeal endoscopic mucosal resection was performed (figure 1A,B). After successful resection of the first specimen, defect evaluation revealed a hole within a white cautery ring, most consistent with a perforation without contamination (sydney deep mural injury (DMI) classification type IV1; figure 1D). A viscous amorphous …

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  • Contributors Drafting of the article: SV; Critical revision of the article for important intellectual content: NS, SG, WAvH and MJB; Final approval of the article: MJB.

  • Funding The Cancer Institute of New South Wales provided funding for a research nurse and data manager to assist with the administration of the study. NS is supported by the University of British Columbia Clinician Investigator Program.

  • Disclaimer There was no influence from either institution regarding study design or conduct, data collection, management, analysis, interpretation, preparation, review, or approval of the manuscript.

  • Competing interests MJB: Research Support: Olympus, Cook Medical, Boston Scientific.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.