"Nutrothorax" complicating a misplaced nasogastric feeding tube in a severely ill patient

Respiratory symptoms due to a twisted nasogastric tube: A case report

Insertion of a nasogastric tube (NGT) is generally considered safe; however, it is not without risk, and in cases of misplacement, complications and even death may occur. In this article, we reported a case of NGT misplacement in a 75-year-old male, which resulted in aspiration pneumonia. We also reviewed published cases of NGT misplacement. Clinicians should pay enough attention to the confirmation of the proper placement of an NGT. A systematic approach for NGT insertion and confirmation is required to prevent misplacement.

Nasogastric tube placement perforating the nasopharynx causing mediastinal passage and feeding into the pleural space

A mid-60s female with known primary progressive multiple sclerosis was admitted to our hospital with aspiration pneumonia. Due to reduced consciousness, a nasogastric (NG) tube was inserted for feeding. A chest x-ray (CXR) report from a thoracic radiologist confirmed an atypical tip position due to a hiatus hernia but concluded it was almost certainly within the stomach. However, after deteriorating on feed commencement, a CT scan of the chest confirmed the tube had perforated the nasopharynx and run parallel to the oesophagus through the mediastinum into the right pleural space. The patient subsequently developed an empyema and pneumothorax, requiring multiple therapeutic interventions and a prolonged hospital stay. This case demonstrates how the routine insertion of an NG tube can lead to serious complications. Additionally, position check CXRs can be difficult to interpret, so the decision to use the tube must be made cautiously by the clinical team.

A Rare Entanglement: Self-Knotting of a Nasogastric Tube

While nasogastric intubation is a commonplace procedure characterized by its utility in enteral feeding and gastrointestinal decompression, instances of unexpected complications are relatively infrequent. Herein, we describe an unusual and rare complication, knot formation, that surfaced during routine patient care. This unique case prompts a re-evaluation of the potential complications associated with nasogastric tube insertion and offers insights into the challenges faced in its management. Through this report, we aim to contribute to the understanding of rare complications in enteral feeding practices.

Fatal Enteral Nutritional Hydrothorax Resulting From Aberrant Placement of a Nasogastric Tube Without Perforation of the Tracheobronchial Tree or Esophagus: A Case Report and Review

Nasogastric feeding tubes are commonly used in medical practice to provide nutritional support to patients who cannot take in an adequate amount of food orally. Although rare, nasogastric tubes errantly placed into the respiratory tract may cause serious complications, including death. We present an unusual autopsy case of a fatal hydrothorax that consisted of the enteric feeding solution following placement of a small-bore feeding tube into the left lung, despite no perforation of the tracheobronchial tree or esophagus. Alternative mechanisms for the formation of an enteral nutritional hydrothorax in the absence of a perforation from a feeding tube can be explained by the properties of the fluid, increased alveolar permeability, and underlying lung damage.