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Bowel perforation due to accidental ingestion of foreign bodies is rare, and large-bowel perforation is rarer [1]. An 87-year-old man was admitted for removal of a foreign body in the colon, which was detected incidentally on computed tomography (CT) following penetration of the sigmoid colon (▶ Fig. 1). The foreign body was not detected on radiography. As the patient had no symptoms or abdominal rigidity, we planned to remove the foreign body endoscopically (▶ Video 1).

On endoscopy, the foreign body was identified to be a fish bone with a sharp end; the point of penetration corresponded with its sharp end (▶ Fig. 2). We pulled the bone in the oral direction and removed it using grasping forceps. After removal, a deep ulcer formed following mucosal edema (▶ Fig. 3). We decided to close the ulcer using the over-thescope-clip (OTSC) system (Ovesco Endoscopy AG, Tübingen, Germany), as regular clipping …