Lung cancer metastasis-induced distal esophageal segmental spasm confirmed by individualized peroral endoscopic myotomy: A case report

Figure 1 Esophageal high-resolution manometry report. A: Low resting pressure of the upper esophagus sphincter; B: Normal pressure of the lower esophagus sphincter; C: Locally increased pressure in the middle and lower esophagus without normal peristalsis (Chicago classification II and III).

Figure 2 Diagnosis and treatment of the patient. A: Esophagogram revealed grade I dilation of the esophageal lumen, segmental stenosis of the distal esophagus, and delayed emptying of barium contrast agent from the esophagus; B: Endoscopy revealed a 2-cm long segment of concentric esophageal stenosis with apparently normal overlying mucosa; C: The cardia had normal contraction and relaxation; D: Computed tomography revealed a right upper lung mass; E: Unclear hierarchy of the esophageal wall at the narrow segment; F: Myotomy at the narrow segment; G: The length of the entire myotomy was approximately 6 cm; H: Esophageal muscle biopsy result; I: Repeated esophagography on postoperative day 54.

Figure 3 Post-peroral endoscopic myotomy esophagography. A: Continuous mucosal folds on postoperative day (POD) 203; B: Continuous mucosal folds on POD 745.