Target Sign: Endoscopic Sign of the Colonic Perforation.

A 68-year-old man underwent an en bloc endoscopic mucosal resection (EMR) of a 20 mm non-granular laterally spreading tumor, type 0-IIa of the Paris classification, in the descending colon (Fig. 1). During the procedure, unintentional resection of the muscularis propria (‘target sign’) was observed immediately (Fig. 2A); the defect was closed by endoscopic clipping using four clips (Fig. 2B); no clinical or radiologic signs of the pneumoperitoneum were present. The patient was discharged two days later, completely asymptomatic. Colonic perforation may occur in 2% 10% of patients