Journal Information
Vol. 56. Issue 2.
Pages 117 (February 2020)
Vol. 56. Issue 2.
Pages 117 (February 2020)
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Iatrogenic Pneumothorax Following Nasogastric Tube Misplacement
Neumotórax iatrogénico tras malposición de sonda nasogástrica
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Galo Granadosa, Amaia Ojangurenb,
Corresponding author
amaiaojanguren@gmail.com

Corresponding author.
, Iñigo Ojangurena,c
a Servicio de Neumología, Departamento de Medicina, Hospital Universitario Vall d’Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
b Servicio de Cirugía Torácica, Departamento de Cirugía, Hospital Universitario Arnau de Vilanova, IRBLleida, Lleida, Spain
c CIBER Enfermedades Respiratorias (CibeRes), Spain
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We report the case of a 73-year-old woman admitted to the neurology department with a suspected diagnosis of ischemic stroke in the middle cerebral artery accompanied by left hemiparesis, dysarthria, and impaired swallowing. Insertion of a nasogastric (NG) tube was indicated for nutritional purposes. After placement of the tube, air was instilled and gastric auscultation was performed, which was difficult to interpret. A follow-up chest X-ray showed the tip of the tube located in the right costophrenic angle (Fig. 1a). After removal of the NG tube, the patient developed dyspnea and tachypnea, requiring oxygen therapy with a fraction of inspired oxygen of 50% to maintain correct saturations. An urgent chest X-ray performed at the bedside showed complete right pneumothorax (Fig. 1b), so a chest tube was placed with subsequent resolution of the clinical picture.

Fig. 1.

(a) Chest X-ray showing nasogastric tube (arrow) in the right hemithorax; (b) complete right pneumothorax (arrow).

(0.04MB).

The placement of an NG tube for nutritional or therapeutic purposes is common practice, although it is not free from complications. In fact, accidental introduction of the tube into the airway occurs in 0.3%–15% of cases.1 However, iatrogenic pneumothorax after NG tube insertion is rare.2 It should be suspected in patients with neurological disorders accompanied by a decreased cough reflex, since in this situation insertion of the NG tube in the airway may go unnoticed. Placement of the tube must be immediately confirmed with X-ray.

References
[1]
B. Çelik, E. Sahin, A. Nadir, M. Kaptanoglu.
Iatrogenic pneumothorax: etiology, incidence and risk factors.
Thorac Cardiovasc Surg, 57 (2009), pp. 286-290
[2]
A. Stefani, C. Ruggiero, B. Aramini, A. Scamporlino.
An unusual drain in the pleural cavity: iatrogenic pneumothorax due to pulmonary misplacement of a nasogastric tube.
Intensive Care Med, 44 (2018), pp. 2290-2291

Please cite this article as: Granados G, Ojanguren A, Ojanguren I. Neumotórax iatrogénico tras malposición de sonda nasogástrica. Arch Bronconeumol. 2020;56:117.

Copyright © 2019. SEPAR
Archivos de Bronconeumología

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