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Intrapleural placement of a nasogastric tube: an unusual complication of nasotracheal intubation.

Authors
  • Fisman, D N
  • Ward, M E
Type
Published Article
Journal
Canadian journal of anaesthesia = Journal canadien d'anesthésie
Publication Date
Dec 01, 1996
Volume
43
Issue
12
Pages
1252–1256
Identifiers
PMID: 8955977
Source
Medline
License
Unknown

Abstract

Our experience with this case and a review of the relevant literature suggest that such trauma may predispose to malplacement of nasogastric tubes. Clinical signs, such as aspiration of fluid from a nasogastric tube, and auscultation of air insufflated into the stomach, are unreliable; however, the presence of subcutaneous air in the neck on chest radiograph, and the presence of cervical crepitance on physical examination, are valuable signs in the early diagnosis of perforation of the cervical oesophagus. Contrast oesophagography remains the diagnostic manoeuvre of choice in confirming the diagnosis, but early diagnosis will depend on a high index of suspicion and prompt viewing of chest x-rays. The management and the prognosis of such injuries depends on the level of the perforation, delays in diagnosis, and the presence of associated mediastinitis.

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