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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
PNEUMOHYDROTHORAX DUE TO MISPLACEMENT OF NASOGASTRIC FEEDING TUBE
Author
Yusuf Savran*
Email
yusuf.savran@deu.edu.tr
keyword
Enteral nutrition, Feeding tube, Pneumothorax.
Abstract
Enteral feeding is the recommended and most preferred way of nutrition in critically ill patients. Despite many advantages of enteral nutrition; any complication regarding enteral tube positioning may lead to life threatening results. We present a 76-year old man admitted to medical intensive care unit with the diagnosis of acute respiratory failure due to multilobar pneumonia who experienced pneumohydrothorax because of misplacement of the enteral feeding tube. The feeding tube was placed by the staff but radiographic confirmation was neglected although clinical evaluation was done. Soon after enteral feeding was started respiratory mechanics and hemodynamic stability deteriorated. Upon aspiration nutritional supplement was realized in respiratory tract and feeding was stopped immediately. A radiological evaluation showed enteral feeding tube misplacement and pneumohydrothorax in the left lung. The tube was extracted and a chest tube was inserted which drained massive amount of nutritional supplement and air. After stabilization of the patient a new enteral feeding tube was inserted and after radiological and clinical confirmation feeding was restarted. In summary, clinical confirmation of tube placement without radiographic confirmation especially in critically ill patient can be misleading and may delay management of complications related to tube placement.
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