Pneumothorax from intrapleural placement of a nasogastric tube

Anaesthesia and Intensive Care
L Weinberg, D Skewes

Abstract

Nasogastric tube insertion is a commonly performed procedure that can be associated with significant morbidity and even mortality. There is no universally accepted technique to confirm correct placement. Most confirmatory methods are performed after placement, therefore misplacement and potential complications may have already occurred. We report a case where a commonly used bedside confirmatory test gave false reassurance that the nasogastric tube was properly positioned, but a plain chest X-ray revealed a massive pneumothorax due to inadvertent intrapleural placement of the tube. Due to the deficiencies of traditional confirmatory bedside techniques, and the limitations of modern and more sophisticated confirmatory methods, the plain chest X-ray remains the gold standard test to confirm correct nasogastric tube placement. We appraise the methods commonly employed to confirm nasogastric tube placement, and discuss factors that may increase the risk of misplacement.

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Citations

Jan 24, 2009·Journal for Specialists in Pediatric Nursing : JSPN·Sue Peter, Fenella Gill
Sep 13, 2012·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·S PrabhakaranS P A Stawicki
Jan 1, 2009·JBI Library of Systematic Reviews·Janita Pak-Chun ChauHoi-Shan Lo
Oct 9, 2015·Case Reports in Critical Care·Narjis Al SaifRasheed Al-Hubail
Jan 13, 2015·ANZ Journal of Surgery·Menino Osbert CottaKaye Bowers

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