Paul Vishesh, Kupfer Yizhak, Tessler Sidney
Department of Medicine, Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center, Brooklyn, New York, USA.
BMJ Case Rep. 2013 Jan 18;2013:bcr2012007278. doi: 10.1136/bcr-2012-007278.
A 53-year-old dialysis patient was admitted with symptoms of a respiratory tract infection, abdominal pain and vomiting. She aspirated and required intubation. A nasogastric tube was placed with slight difficulty and the patient developed severe epistaxis. The bleeding could not be controlled with mechanical pressure and nasal packing. Angiography revealed extravasation from a pseudoaneurysm arising from the inferior pharyngeal branch of the ascending pharyngeal trunk. The vessel was successfully embolised with cessation of bleeding. We emphasise that even a seemingly easy procedure like insertion of a nasogastric tube, can lead to a life-threatening complication.
一名53岁的透析患者因呼吸道感染、腹痛和呕吐症状入院。她发生了误吸并需要插管。放置鼻胃管时稍有困难，患者随后出现严重鼻出血。机械压迫和鼻腔填塞无法控制出血。血管造影显示，咽升动脉下咽部支形成的假性动脉瘤有造影剂外渗。成功栓塞该血管后出血停止。我们强调，即使是像插入鼻胃管这样看似简单的操作，也可能导致危及生命的并发症。
