An Unusual Small Bowel Mass: India Ink Tattooing Mimicking Malignancy

Kunal Kochar, MD, Ajit Pai, MD, Slawomir Marecik, MD, John Park, MD, Leela Prasad, MD

Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA (all authors).


Introduction: India ink is routinely used for preoperative marking of colonic lesions to facilitate identification during laparoscopic colon surgery. It is a relatively inert dye with few reported adverse effects.

Case Description: We report a case of inadvertent extracolonic tattooing and intra-peritoneal spillage of India ink leading to adhesions and formation of a mass, which mimicked malignancy. The relevant literature is also reviewed.

Discussion: Although India ink is a safe dye for colonic tattooing and most of its complications are asymptomatic, it can occasionally lead to complications that might mimic malignancy and cause a diagnostic dilemma.

Key Words: India ink, Small bowel mass, Malignancy, Complication, Endoscopy.

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