Challenging removal of a knotted nasogastric tube following insertion under general anaesthetic. Issue 10 (29th October 2020)

• Record Type: Journal Article
• Authors: Conroy, Michael; Wichmann, Katherine; Farkas, Nicholas; Di-Nicola, Valerio
• Is Part Of: BMJ case reports. Volume 13:Issue 10(2020)
• Publication Date: 2020-10-29
• Subjects: ear -- nose and throat/otolaryngology -- surgery -- general surgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-238213
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 74-year-old man presented with acute small bowel obstruction secondary to recurrence of a caecal tumour. The patient underwent laparotomy and formation of loop ileostomy and had a nasogastric tube (NGT) inserted in the theatre. A decision was made to remove the patient's NGT postoperatively, which was found to be stuck. High-quality imaging demonstrated a knot in the tube within the nasopharynx; so, subsequent removal via the oral route necessitated sedation. This case highlights the importance of considering rare or unusual complications of NGT insertion when a patient describes more pain or discomfort than would otherwise be expected. The clarity of imaging highlights clearly the underlying findings when compared with the few other documented cases. We offer a number of learning points specific to this complication.