Tracheopulmonary complications following placement of a nasogastric (NG) feeding tube are uncommon but can cause significant morbidity and mortality. In this case report, an 83-year-old woman of American Society of Anesthesiologists class IV with underlying pulmonary disease required placement of an NG feeding tube after surgical treatment of primary squamous cell carcinoma of the tongue. Malpositioning of the NG feeding tube into the right pleural space was confirmed by computed tomography. Removal of the NG feeding tube resulted in a tension pneumothorax that necessitated chest tube placement. Because of the difficulty of blind NG feeding tube placement in this patient, the subsequently placed NG feeding tube was successfully positioned with the aid of a video laryngoscope. This case report illustrates the risk of NG feeding tube malpositioning in a nasally intubated patient undergoing head and neck surgery and discusses improvements in techniques for proper NG feeding tube placement.
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Fall 2020
case report|
September 29 2020
Tracheopulmonary Complications of a Malpositioned Nasogastric Tube
David B. Guthrie, DMD;
*Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York
†Department of Anesthesiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
Address correspondence to Dr David B. Guthrie, Department of Oral and Maxillofacial Surgery, Division of Dental Anesthesiology, 148B Rockland Hall, Stony Brook, NY 11794-8711; david.guthrie2@stonybrookmedicine.edu
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James P. Pezzollo, DMD;
James P. Pezzollo, DMD
*Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York
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David K. Lam, MD, DDS, PhD;
David K. Lam, MD, DDS, PhD
*Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York
‡Department of Surgery, Stony Brook Medicine, Stony Brook, New York
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Ralph H. Epstein, DDS
Ralph H. Epstein, DDS
*Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York
†Department of Anesthesiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
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Anesth Prog (2020) 67 (3): 151–157.
Article history
Received:
February 14 2019
Accepted:
September 23 2019
Citation
David B. Guthrie, James P. Pezzollo, David K. Lam, Ralph H. Epstein; Tracheopulmonary Complications of a Malpositioned Nasogastric Tube. Anesth Prog 1 September 2020; 67 (3): 151–157. doi: https://doi.org/10.2344/anpr-67-01-02
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