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.

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 …