Subedi Yogesh, Adhikari Biplov, Pokharel Ashik, Poudel Kalyan, Sharma Sajja
Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA.
Internal medicine, MedStar Union Memorial Hospital, Baltimore, USA.
Cureus. 2023 Jan 9;15(1):e33535. doi: 10.7759/cureus.33535. eCollection 2023 Jan.
Orogastric tube (OGT) insertion is a routine procedure in medical care. It is often inserted in patients after endotracheal intubation. OGT insertion is often a blind procedure. Misplacement of the tube can cause a variety of complications and can sometimes be life-threatening. We present the case of a 71-year-old male patient who experienced a rare proximal esophageal perforation as a complication of blind insertion of the OGT; he required OGT insertion after receiving endotracheal intubation for hypoxic respiratory failure secondary to COVID-19 infection. The esophageal perforation was revealed on a post-procedural roentgenogram and confirmed by a subsequent computed tomography of the chest. Given the small size of the perforation and the absence of clinical instability, conservative management was pursued leading to improvement of the mediastinitis. Although the complications of OGT insertion are uncommon, their consequences can be potentially serious and require a high degree of suspicion.
经口胃管(OGT)插入是医疗护理中的常规操作。通常在患者进行气管插管后插入。OGT插入往往是一种盲插操作。导管误置会导致各种并发症,有时甚至会危及生命。我们报告一例71岁男性患者,因OGT盲插并发罕见的食管近端穿孔;该患者因新型冠状病毒肺炎感染继发缺氧性呼吸衰竭接受气管插管后需要插入OGT。术后X线片显示食管穿孔,并经随后的胸部计算机断层扫描证实。鉴于穿孔较小且无临床不稳定情况,采取了保守治疗,纵隔炎得到改善。虽然OGT插入的并发症并不常见,但其后果可能很严重,需要高度怀疑。