Although tattooing is widely used and relatively safe, the presented case indicates the risk of infection or inflammation by tattooing. Histologic examination of the edematous tattooing area revealed an ink abscess spreading laterally above the muscularis propria. The distal resection margin was extended approximately 5 cm more than expected because of long extent of edematous mucosa. A total of 184 tattoo sites were identified. aim was to identify the lesion through the laparoscope by looking for the serosal surface stained or inflamed by ICG injection. During the laparoscopic operation, the proximal and distal margin of the lesion appeared edematous with bluish color. India ink tattoos properly placed in the colorectum are long-lasting and are reported to remain constant therefore, they are being commonly used for colonic tattooing. Authors encountered a case of a 60-year-old man with a resectable sigmoid colon cancer which was tattooed with India ink for subsequent localization in the intraoperative setting. Although the mechanism of complication is not completely understood, it may be related to the chemical compounds contained in the ink solution and enteric or extraenteric bacterial inoculation by injection needle or the ink itself. However, significant complications have been reported, including local inflammatory pseudotumor formation, peritonitis, rectus muscle abscess, small bowel infarction, and phlegmonous gastritis. Endoscopic tattooing with India ink is generally regarded as a safe procedure that enables ready identification of endoluminal cancer from the serosal surface. India ink injected into dog colon.9 From these initial studies, it was demonstrated that India ink is the most eective agent based on permanence and limited biologic reaction the tattoo dye.9 India ink seemed to persist for the greatest time.
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