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Intra‐abdominal nasogastric tube placement following inadvertent nasopharyngeal perforation

Intra‐abdominal nasogastric tube placement following inadvertent nasopharyngeal perforation We report the case of a patient who had a nasogastric tube inserted following cardiac surgery that was determined to be appropriately sited on chest X‐ray. Following initiation of nasogastric feeding, however, the patient became acutely unwell. Subsequent computed tomography imaging demonstrated that the nasogastric tube had perforated through the posterior nasopharynx and passed through the mediastinum into the abdominal cavity. A laparotomy and washout was required, and following a prolonged intensive care stay with multiple further interventions, the patient ultimately survived to discharge. Pharyngeal wall perforation is a rare but serious complication of attempted nasogastric tube insertion. Risk factors include the need for repeated attempts and patients with an altered mental state. The appropriate steps in confirming the position of nasogastric tubes both clinically and radiologically are reviewed in the context of this rare and serious complication. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Reports Wiley

Intra‐abdominal nasogastric tube placement following inadvertent nasopharyngeal perforation

Walmsley, C. J.; Comben, E. J.
Anaesthesia Reports , Volume 8 (1) – Jan 1, 2020
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References (11)

Publisher
Wiley
Copyright
2020 © Association of Anaesthetists
eISSN
2637-3726
DOI
10.1002/anr3.12044
Publisher site
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Abstract

We report the case of a patient who had a nasogastric tube inserted following cardiac surgery that was determined to be appropriately sited on chest X‐ray. Following initiation of nasogastric feeding, however, the patient became acutely unwell. Subsequent computed tomography imaging demonstrated that the nasogastric tube had perforated through the posterior nasopharynx and passed through the mediastinum into the abdominal cavity. A laparotomy and washout was required, and following a prolonged intensive care stay with multiple further interventions, the patient ultimately survived to discharge. Pharyngeal wall perforation is a rare but serious complication of attempted nasogastric tube insertion. Risk factors include the need for repeated attempts and patients with an altered mental state. The appropriate steps in confirming the position of nasogastric tubes both clinically and radiologically are reviewed in the context of this rare and serious complication.

Journal

Anaesthesia Reports – Wiley

Published: Jan 1, 2020

Keywords: critical care; gastrointestinal intubation; general surgery; patient safety; pharynx; radiology

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