Staten Island University Hospital, Northwell Health
Staten Island, NY
HRM is a technique that facilitates the diagnosis of esophageal motility disorders utilizing a specialized catheter with delicate pressure sensors along the length of the catheter. Endoscopic manipulation can damage the catheter and its sensors, rendering it unusable. The cost of the catheter approaches $19000, and once damaged, it cannot be repaired. Using a Roth Net to gently guide the catheter through the LES may be a reasonable alternative to aborting the procedure. We propose the use of the Roth Net for safe and effective placement of motility catheters in cases where coiling or resistance at the LES precludes routine catheter placement. Prompt placement can reduce procedure time and anesthesia-related complications.
Figure#1A: EGD showing esophageal dilatation
Figure#1B: Barium esophagogram showing dilated esophagus with distal spasm (Blue arrow) Figure#1C: Coiling of manometry catheter in the esophagus
Figure#1D: Tip of the manometry catheter was captured by the Roth net
Figure#1E: Successful placement of the catheter in the antrum of the stomach
Figure#2: Manometry report showing findings consistent with achalasia.
Figure#3: High Resolution Manometry Set up (A) with Manometry catheter (B), Biopsy forceps (C), Rat tooth Forceps (D) displaying sharp interdigitated teeth could be a potential damage to the manometry catheter, (E) Roth net
Dhineshreddy Gurala indicated no relevant financial relationships.
Jobin Philipose indicated no relevant financial relationships.
Abhishek Polavarapu indicated no relevant financial relationships.
Youssef Eldouaihy indicated no relevant financial relationships.
Pretty Sara Idiculla indicated no relevant financial relationships.
Stephen Mulrooney indicated no relevant financial relationships.