Metallic clip-associated colonic perforation after peroral endoscopic myotomy: A case report

Figure 1 Imaging results. A: Metallic clips were used to close the mucosal layer after peroral endoscopic myotomy surgery; B: Upper gastrointestinal contrast study was performed on postoperative day 3 after peroral endoscopic myotomy, revealing several metallic clip shadows (arrow) in the distal esophagus; C: Abdominal computed tomography scan showed a metal clip was identified adjacent to the perforation site (arrow); D: Coronal computed tomography image clearly depicted the clip (arrow); E: Laparoscopic exploration showed a metal clip was identified adjacent to the perforation site (arrow); F: Resected sigmoid specimen; G: Submucosal abscess with mixed neutrophilic and lymphocytic infiltration (intestinal wall); H: Submucosal abscess with mixed inflammation, necrosis, and focal vascular congestion (intestinal wall); I: Fibroadipose tissue with abscess, mixed inflammation, and focal vascular dilation/hemorrhage (mesentery).