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Images show clips in the distal oesophagus on the scout radiograph, compatible with the patient's recent Per-oral oesophageal myotomy (POEM) procedure.
On the water-soluble images, there was no leak.
On the subsequent barium images, one can see how the lower oesophageal sphincter is now wider than with achalasia. On the LPO image, a small amount of barium adheres to the clips, showing their submucosal location.