phProbe Survey...where is the LES?

 
1. We are often asked to assist in placement of a ph probe in children of various ages. The electrode is supposed to be at a level of 2.5 cm above the location of the lower esophageal sphincter. Since we are not aware of a suitable landmark for the LES, we would welcome the input from the membership as to where they would place the LES on a frontal chest film. We have noted the level of T10 in each of the 4 cases
2. Are you asked to help in placement of the lower esophageal sphincter in patients who are having a ph probe study, using a frontal chest film?
3. Please locate where you would place the LES in the following 4 patients, which are of varying ages: You can choose numbers 1 through 5 or anywhere in-between. We are only interested in where you would feel the LES is located in each of these cases.
Case 1- 8mo old
Image as described above
4. Where would you place the location of the lower esophageal sphincter (LES)on Case 1? Choose anywhere along the line, from 1 to 5 or anywhere in between
Case 2 5y9mo
Image as described above
5. Where would you place the location of the lower esophageal sphincter (LES)on Case 2? Choose anywhere along the line, from 1 to 5 or anywhere in between
Case 3 13y5mo
Image as described above
6. Where would you place the location of the lower esophageal sphincter (LES)on Case 3? Choose anywhere along the line, from 1 to 5 or anywhere in between
Case 4 3y4mo
Image as described above
7. Where would you place the location of the lower esophageal sphincter (LES) on Case 4? Choose anywhere along the line, from 1 to 5 or anywhere in between
8. Do you use a certain anatomic landmark to determine the level of the LES? If "yes" please explain.
9. How long have you been practicing Pediatric Imaging?
10. Thank you very much for your input! We shall tabulate the responses and present them to the membership as a brief presentation or poster
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