Clinical outcomes and safety of high-resolution manometry guided superficial partial circular muscle myotomy in per-oral endoscopic myotomy for Jackhammer esophagus: Two cases report

Figure 2 The examination of 47-year-old man conducted before superficial circular muscle per-oral esophageal myotomy. A: Pre-treatment high-resolution manometry (HRM) showed high-amplitude distal esophageal contractions with a distal contractile integral (DCI) value > 8000 mmHg.s.cm for 8 of a total of 10 swallows and the highest DCI value was 13553 mmHg.s.cm; B-D: Pre-treatment esophagography showed spasmodic contraction of the distal esophagus (C) Post-treatment HRM revealed within normal range of DCI (D) Post-treatment esophagogram showed improved function of passage of esoaphagus.