The long life of a hemoclip.

An 87-year-old male with frequent episodes of food impaction underwent esophageal high-resolution manometry, which revealed type-I achalasia. Due to his advanced age and the presence of comorbidities, botulinum toxin injection was proposed and accepted by the patient. In June 2021, esophagogastroduodenoscopy revealed an esophageal dilatation with liquid and food retention and narrowing of the esophagogastric junction. An injection of 25 units of botulinum toxin diluted in 10 mL of saline was administered in each of the 4 lower esophageal sphincter quadrants, with no complications.