Pediatric Esophageal Temperature Probe Malfunction

  • Etiology: Placed in patients who require monitoring of core body temperature in cardiac surgery or in cooling treatment for hypoxic ischemic encephalopathy
  • Imaging: Correct position of the esophageal temperature probe tip is in the distal esophagus
  • Note: Sometimes you may see an additional temperature probe placed with its tip in an axillary position
  • Note: Sometimes you may see an additional temperature probe placed with its tip in the rectum
  • DDX: Esophageal temperature probe mimics include esophageal pH probe which has numerous linear marks along its length, 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 esophageal temperature probe tip too high in the esophagus
    — Malposition of the esophageal temperature probe tip too low in the stomach
    — Perforation of the esophagus during placement of the esophageal temperature probe
  • Treatment: Repositioning or replacement of malpositioned esophageal temperature probe
  • Clinical: Most sensitive way to measure core body temperature

Radiology Cases of Esophageal Temperature Probe Malfunction

Radiology Cases of Esophageal Temperature Probe Correct Position

AXR of umbilical arterial catheter in the celiac artery
CXR AP shows the tip of the umbilical arterial catheter to be in the celiac artery. The tip of the umbilical venous catheter is at the junction of the inferior vena cava and right atrium. Esophageal temperature probe tip projects over the mid-esophagus. The patient is lying upon a cooling blanket.
CXR of esophageal temperature probe
CXR AP shows a nasogastric tube coursing within the esophagus into the stomach while the twisted wire probe next to it with its tip in the mid-esophagus represents an esophageal temperature probe in appropriate position. The patient is lying upon a cooling blanket while being cooled to treat their hypoxic ischemic encephalopathy.
CXR of esophageal temperature probe in correct position
CXR AP shows a nasogastric tube coursing in the esophagus with its tip in the body of the stomach. The twisted wire probe coursing next to it with its tip in the mid-to-distal esophagus represents an esophageal temperature probe. Another twisted wire temperature probe is present in the left axilla.

Radiology Cases of Esophageal Temperature Probe Incorrect Position

CXR of esophageal temperature probe tip too low in position in the stomach
CXR AP shows a nasogastric tube coursing in the esophagus with its tip in the body of the stomach. The twisted wire probe coursing next to the nasogastric tube with its tip in the body of the stomach represents an esophageal temperature probe. Another twisted wire temperature probe is present in the left axilla.