Nasotracheal intubation and pulmonary parenchymal perforation. An unusual complication of naso-enteral feeding with small-diameter feeding tubes.

If not used cautiously, the rigid guide wire used with small-diameter feeding tubes can promote nasotracheal intubation in patients with diminished tracheobronchial sensation. Patients with endotracheal tubes are also at risk. To prevent pulmonary complications with small-diameter feeding tubes, the wire introducer should not be advanced beyond the nasopharynx, and x-ray verification of catheter location should be mandatory.