Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	121137
DOI	10.4240/wjgs.121137
Country	China

Category	Surgery
Manuscript Type	Case Report
Article Title	Metallic clip-associated colonic perforation after peroral endoscopic myotomy: A case report
Manuscript Source	Unsolicited Manuscript
All Author List	Geng-Yuan Zhang, Shi-Gong Chen, Zhong-Ti Gao, Zhu-Tang Huang, Sheng-Fu Che, Long Li, Bo Long, Fei-Fei Ding, Ze-Yuan Yu, Hui-Nian Zhou and Zuo-Yi Jiao
Funding Agency and Grant Number	Funding Agency Grant Number National Natural Science Foundation of China 82460459 Gansu Provincial Health and Wellness Industry Scientific Research Project GSWSKY2024-03 Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital CY2022-QN-A13 Lanzhou Science and Technology Plan Project 2023-4-26
Corresponding Author	Zuo-Yi Jiao, Professor, Department of General Surgery, The Second Hospital & Clinical Medical School, Lanzhou University, No. 82 Cuiying Gate, Chengguan District, Lanzhou 730030, Gansu Province, China. jiaozy@lzu.edu.cn
Key Words	Colonic perforation; Peroral endoscopic myotomy; Achalasia; Chronic constipation; Case report
Core Tip	Colonic perforation potentially related to metallic clip migration after peroral endoscopic myotomy is an unprecedented complication. This case of a 48-year-old woman with achalasia and chronic constipation demonstrates that clip dislodgement may lead to clip-associated acute sigmoid colon perforation, requiring urgent sigmoid colectomy with colostomy. Clinicians should remain vigilant for sudden abdominal pain in post-peroral endoscopic myotomy patients, especially those with chronic constipation, and consider clip-associated injury as a potential etiology.
Citation	Zhang GY, Chen SG, Gao ZT, Huang ZT, Che SF, Li L, Long B, Ding FF, Yu ZY, Zhou HN, Jiao ZY. Metallic clip-associated colonic perforation after peroral endoscopic myotomy: A case report. World J Gastrointest Surg 2026; In press DOI: https://doi.org/10.4240/wjgs.121137
PDF	121137-in-press.pdf

Received	2026-03-21 12:22
Peer-Review Started	2026-03-21 12:22
First Decision by Editorial Office Director	2026-04-28 01:46
Return for Revision	2026-04-28 03:41
Revised	2026-05-14 03:25
Publication Fee Transferred	2026-05-17 10:03
Second Decision by Editor	2026-06-26 02:16
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-26 03:22
Articles in Press	2026-06-26 03:22
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Typeset the Manuscript

ISSN	1948-9366 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Copyright	Colonic perforation potentially related to metallic clip migration after peroral endoscopic myotomy is an unprecedented complication. This case of a 48-year-old woman with achalasia and chronic constipation demonstrates that clip dislodgement may lead to clip-associated acute sigmoid colon perforation, requiring urgent sigmoid colectomy with colostomy. Clinicians should remain vigilant for sudden abdominal pain in post-peroral endoscopic myotomy patients, especially those with chronic constipation, and consider clip-associated injury as a potential etiology.
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