RT Journal Article
SR Electronic
T1 Case of nasogastric tube dysfunction
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP gutjnl-2017-315619
DO 10.1136/gutjnl-2017-315619
A1 Florian Rainer
A1 Guenther Prenner
A1 Lukas Peter Binder
A1 Peter Fickert
A1 Johannes Plank
YR 2018
UL http://gut.bmj.com/content/early/2018/01/05/gutjnl-2017-315619.abstract
AB Clinical presentation An elderly female patient was admitted to intensive care for prolonged vasopressor therapy and mechanical ventilation after cardiac arrest and acute percutaneous coronary intervention. Antiplatelet, thyroid hormone replacement and statin therapies were administered through a 14-French nasogastric tube (Nestlé Health Science) and enteral feeding was initiated. Correct position of the nasogastric tube was confirmed radiologically. On the seventh day in the intensive care, our patient was seen to regurgitate soft crumbs into her mouth. The blocked nasogastric tube was removed, but attempts to reinsert another tube failed.Upper GI endoscopy revealed an obstruction of the oesophagus with a milky-yellowish caseous substance 20 cm from the incisors (figure 1). The proximal part of the mass showed a central hole and ring-shaped layers resembling the cut face of a tree trunk.Figure 1 Obstruction of the oesophagus with a milky-yellowish caseous substance.Questions What caused the obstruction?How should we manage such a problem?