Buckled Transesophageal Echocardiography Probe: A Stepwise Approach to Diagnosis and Management of a High-Risk Complication.

BACKGROUND

Buckling of a transesophageal echocardiography (TEE) probe is a rare but potentially life-threatening complication that carries a significant risk of esophageal perforation.

CASE SUMMARY: We report 3 cases of buckled TEE probes that were promptly recognized, diagnosed, and managed using multimodal imaging. In each instance, the location of the buckled probe was confirmed with bedside imaging. Subsequently, the patient was taken to the interventional suite for advancement of the probe to the stomach under fluoroscopic guidance. Finally, the buckled TEE probe was straightened and removed successfully from the patient without difficulty.

DISCUSSION: Early recognition of buckled TEE probes and employment of a structured, algorithmic management approach are essential to optimizing outcomes and preventing associated morbidity and mortality.

TAKE HOME MESSAGES: Buckling of the TEE probe requires a high index of suspicion and prompt diagnosis to prevent catastrophic complications such as esophageal perforation. Advancement of the TEE probe in the stomach under fluoroscopic guidance facilitates straightening and removal of the probe without the risk of esophageal perforation.