case_images: PMC11828667_01
case_images: Quantitative evaluation of GER by MII-pH. (A) Schematic representation of the recording assembly. The MII-pH catheter had one pH channel within the esophagus and four impedance segments corresponding to each pair of electrodes, recording reflux at the lower, middle, upper thoracic, and cervical esophagus. (B, C) GER events detected by MII-PH. Each bar is an episode of GER. All data from 24-hour records are shown. The vertical axis indicates the height reached by refluxed liquid, and the horizontal axis shows the duration of reflux episodes detected by MII-pH before (B; day 92) and after treatment for GER (C; day 117). The * mark indicates a GER episode accompanied by apnea.. GER: gastroesophageal reflux, MII-pH: multichannel intraluminal impedance-pH monitoring. Image Credit: Masanori Inoue
case_images: cureus-0017-00000077504-i01.jpg
case_images: PMC11828667_01_cureus-0017-00000077504-i01.jpg
case_images: FIG1
case_images: On the same day, an MII-pH catheter (CZPN-BG-5; Sandhill Scientific, Highlands Ranch, CO, USA) was inserted through the nostril and positioned under fluoroscopic guidance, with the pH channel placed in the lower esophagus and the four impedance segments positioned in the lower, middle, upper thoracic, and cervical esophagus (Figure 1A). Scientific, Highlands Ranch, CO, USA), and 40 GER episodes were recorded over 24 hours (Figure 1B). Six GER events involving reflux lasting more than three seconds to the cervical esophagus were identified during this monitoring period. Following the abovementioned interventions, the symptomatic apnea episodes reduced to once every three to four days by DOL 107 (PMA 44 weeks and three days), and a repeat MII pH probe on DOL 117 (PMA 45 weeks and six days) detected 35 episodes with no episode lasting >3 seconds in the cervical esophagus (Figure 1C).