Andreoli Steven M, Schrum Stefanie, McGoogan Katherine
From the Division of Pediatric Otolaryngology, Nemours Children's Health, Jacksonville, FL.
Department of Pediatric Anesthesiology, Nemours Children's Health, Jacksonville, FL.
JPGN Rep. 2023 Mar 13;4(2):e299. doi: 10.1097/PG9.0000000000000299. eCollection 2023 May.
The Bravo pH probe is a wireless capsule allowing remote quantification of gastroesophageal reflux. A 14-year-old male presented for Bravo probe placement. Following esophagogastroduodenoscopy, attachment of the Bravo probe was attempted. Immediately, the patient began coughing without oxygen desaturation. Repeat endoscopy did not reveal the probe within the esophagus or stomach. He was then intubated, and fluoroscopy demonstrated a foreign body within the bronchus intermedius. Rigid bronchoscopy was performed to retrieve the probe using optical forceps. This is the first case of pediatric inadvertent airway deployment requiring retrieval. We recommend endoscopic visualization of the delivery catheter entering the cricopharyngeus before Bravo probe deployment, then followed by repeat endoscopy to confirm position of the probe after attachment.
Bravo pH探头是一种无线胶囊,可对胃食管反流进行远程定量分析。一名14岁男性前来进行Bravo探头放置。在进行食管胃十二指肠镜检查后,尝试附着Bravo探头。随即,患者开始咳嗽,但未出现氧饱和度下降。再次进行内镜检查时,未在食管或胃内发现探头。随后对其进行插管,荧光透视显示中间支气管内有一异物。遂行硬质支气管镜检查,用光学钳取出探头。这是首例需要取出的小儿意外气道置入探头的病例。我们建议在放置Bravo探头前,通过内镜观察输送导管进入环咽肌的情况,放置后再通过重复内镜检查确认探头位置。