Pediatric Esophageal pH Probe Malfunction

  • Etiology: Placed in patients who require evaluation and quantification of gastroesophageal reflux
  • Imaging: Correct position of the esophageal pH probe sensor is 3-5 centimeters above the gastroesophageal junction
  • Note: Make sure you know which of the radiopaque markings on the catheter is the actual pH probe sensor
  • DDX: Esophageal ph probe mimics include esophageal temperature probe which has a twisted wire appearance, nasogastric tube which does not have a pointed end, NAVA tube which has pointed end and transesophgeal echocardiogram probe which has a very wide diameter and a sensor at the end
  • Complications:
    — Malposition of the pH probe sensor too high in the esophagus
    — Malposition of the pH probe sensor too low in the stomach
    — Perforation of the esophagus during placement of the pH probe
  • Treatment: Repositioning or replacement of malpositioned esophageal pH probe
  • Clinical: Most sensitive way to measure gastroesophageal reflux

Radiology Cases of Esophageal pH Probe Malfunction

Radiology Cases of Esophageal pH Probe in Correct Position

CXR of correct position of esophageal pH probe sensor / measurement lead
CXR AP shows the tip of the nasogastric tube to be in the stomach. The position of the esophageal pH probe sensor / measurement lead (the radiolucent cylinder with the radiopaque stripe in the center of it) is 3-5 cm above the gastroesophageal junction.
CXR of correct position of the esophageal pH probe sensor / measurement lead
CXR AP shows an esophageal pH probe. The position of the esophageal pH probe sensor / measurement lead (the radiolucent cylinder with the radiopaque stripe in the center of it) is 3-5 cm above the gastroesophageal junction.

Radiology Cases of Esophageal pH Probe in a Too Low a Position

CXR of esophageal pH probe malposition
CXR AP shows an esophageal pH probe. The position of the esophageal pH probe sensor / measurement lead (the radiolucent cylinder with the radiopaque dot in the center of it) is at the gastroesophageal junction.