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Per-oral esophageal myotomy (POEM)

Case contributed by Matt A. Morgan
Diagnosis certain

Presentation

Patient less than 1 hour post a per-oral esophageal myotomy procedure (POEM) for achalasia. Asymptomatic.

Patient Data

Age: 35 years
Gender: Female

Images show clips in the distal esophagus on the scout radiograph, compatible with the patient's recent Per-oral esophageal myotomy (POEM) procedure.

On the water-soluble images, there was no leak.

On the subsequent barium images, one can see how the lower esophageal sphincter is now wider than with achalasia. On the LPO image, a small amount of barium adheres to the clips, showing their submucosal location. 

Case Discussion

Per-oral esophageal myotomy (POEM) is an increasingly-used technique to treat achalasia, in the place of the more traditional open myotomy with fundoplication.

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