Taira Kenkichiro, Koyama Satoshi, Morisaki Tsuyoshi, Fukuhara Takahiro, Donishi Ryouhei, Fujiwara Kazunori
Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.
Case Rep Gastroenterol. 2023 Apr 13;17(1):191-196. doi: 10.1159/000526715. eCollection 2022 Jan-Dec.
Nasogastric tube syndrome (NGTS) induced by a nasointestinal ileus tube is an uncommon but potentially life-threatening complication. NGTS often becomes serious and progresses to acute upper airway obstruction caused by bilateral vocal cord paralysis or laryngeal infection. Early detection and proper treatment of NGTS are necessary. We describe the case of a 78-year-old patient with this syndrome induced by a nasointestinal ileus tube. At administration, ileus was suspected based on physical examination and thoracoabdominal X-ray findings. A nasointestinal ileus tube was placed through the left nasal cavity. Three days after tube placement, hoarseness and wheezing were found during nutrition support team rounds. Upper airway obstruction was suspected and evaluated immediately with flexible laryngoscopy by an otolaryngologist. The nasointestinal ileus tube was removed. The symptoms decreased with prompt proper management. Immediate removal of the tube and early recognition of symptoms are the first steps in the treatment for this syndrome, in addition to the initiation of steroid, proton pump inhibitor, and antibiotic therapy. The cause of NGTS is thought to be continuous pressure on the hypopharynx and cervical esophagus. NGTS should be considered in patients with either nasogastric or nasointestinal ileus tubes. Early diagnosis and proper management of NGTS are important.
鼻肠肠梗阻导管引起的鼻胃管综合征（NGTS）是一种罕见但可能危及生命的并发症。NGTS通常会变得严重，并进展为双侧声带麻痹或喉部感染引起的急性上呼吸道梗阻。早期发现和妥善治疗NGTS很有必要。我们描述了一例由鼻肠肠梗阻导管引起该综合征的78岁患者的病例。置入导管时，根据体格检查和胸腹部X线检查结果怀疑存在肠梗阻。通过左鼻腔置入一根鼻肠肠梗阻导管。置管三天后，营养支持团队查房时发现患者声音嘶哑和喘息。怀疑存在上呼吸道梗阻，耳鼻喉科医生立即通过纤维喉镜进行评估。取出鼻肠肠梗阻导管。经过及时妥善处理，症状有所减轻。除了开始使用类固醇、质子泵抑制剂和抗生素治疗外，立即取出导管并早期识别症状是该综合征治疗的首要步骤。NGTS的病因被认为是下咽和颈段食管受到持续压迫。使用鼻胃管或鼻肠肠梗阻导管的患者均应考虑NGTS。早期诊断和妥善处理NGTS很重要。
