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Endoscopic tattooing was performed in the past using sterilized solutions of India ink, which often contained immunologically active proteins and occasionally caused complications that included sterile abscesses and even development of inflammatory bowel disease. Now, sterile suspensions of pure carbon black (Spot; GI Supply) are typically used and assumed to be inert and safe for injection. To investigate this assumption, researchers from a large center for endoscopic mucosal resection (EMR) of colonic lesions prospectively reviewed cases involving tattoo-related complications.
Four cases were identified during 5 years. The first was a 45-mm, granular lateral-spreading tumor of the descending colon that had been previously injected and tatt…