Urology, Medway Maritime Hospital, Gillingham, UK
General Surgery, Worthing Hospital, Worthing, UK.
BMJ Case Rep. 2020 Oct 29;13(10):e238213. doi: 10.1136/bcr-2020-238213.
A 74-year-old man presented with acute small bowel obstruction secondary to recurrence of a caecal tumour. The patient underwent laparotomy and formation of loop ileostomy and had a nasogastric tube (NGT) inserted in the theatre. A decision was made to remove the patient's NGT postoperatively, which was found to be stuck. High-quality imaging demonstrated a knot in the tube within the nasopharynx; so, subsequent removal via the oral route necessitated sedation. This case highlights the importance of considering rare or unusual complications of NGT insertion when a patient describes more pain or discomfort than would otherwise be expected. The clarity of imaging highlights clearly the underlying findings when compared with the few other documented cases. We offer a number of learning points specific to this complication.
一位 74 岁男性因盲肠肿瘤复发导致急性小肠梗阻就诊。患者接受了剖腹手术，并形成了回肠造口术，术中插入了鼻胃管（NGT）。术后决定拔除患者的 NGT，但发现其被卡住了。高质量的影像学检查显示，在鼻咽部的管子里有一个结；因此，需要通过口腔途径进行镇静后才能取出。本病例强调了在患者描述的疼痛或不适程度超过预期时，考虑 NGT 插入罕见或不常见并发症的重要性。与其他少数有记录的病例相比，影像学的清晰度清楚地突出了潜在的发现。我们提供了一些针对这种并发症的具体学习要点。
