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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. 1Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Westmead 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}citywestgastro.com.au

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Introduction

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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Footnotes

  • 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.

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