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A case of a ‘lost’ nasogastric tube

Published online by Cambridge University Press:  26 October 2012

V Sankar ,
M Shakeel ,
S Keh  and
K W Ah-See
V Sankar*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, UK
M Shakeel
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, UK
S Keh
Affiliation:
Department of Otolaryngology, St John's Hospital, Edinburgh, Scotland, UK
K W Ah-See
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, UK
*
Address for correspondence: Mr V Sankar, Ward 45, Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UK Fax: +44 (0)1224 554 569 E-mail: [email protected]
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Abstract

Objectives:

To present the case of a ‘lost’ nasogastric tube and to highlight the importance of imaging and/or chest X-ray after nasogastric tube insertion, especially in unreliable patients.

Case report:

A 50-year-old man, undergoing radiotherapy treatment for squamous cell carcinoma of the tongue base, was admitted for pain control and nasogastric tube feeding. This patient required multiple nasogastric tubes over a two-week period. The patient repeatedly denied pulling the nasogastric tube out and we were unable to establish the exact mode of nasogastric tube removal. On one such occasion another tube was inserted and a check X-ray showed two feeding tubes; the latest one was lying in the left main bronchus and the old nasogastric tube was observed in the oesophagus, with its upper end jutting above the hypopharynx. It was apparent that the patient had somehow cut the tube and swallowed it.

Conclusion:

This case not only illustrates the importance of flexible nasendoscopy and/or chest X-ray for checking the position of the nasogastric tube, but also highlights that some patients are not tolerant of nasogastric tubes. The use of nasogastric tubes should be avoided in these patients to prevent any self-inflicted injury.

Keywords

IntubationNasogastricEnteral Nutrition
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 12 , December 2012 , pp. 1296 - 1298
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented as a poster at the annual meeting of ENT UK, 11 September 2009, London, UK.

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