Volume 2016, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426


Nasogastric tubes are widely used for enteral feeding and administration of medication but unexpected complications can arise during their insertion or removal. There are no standardized ways of dealing with such complications and the safer methods of insertion available are mostly expensive. We present here a case of knotted nasogastric tube and the different approaches that were used to remove it. A brief review of the literature on nasogastric position confirmation techniques is also presented.


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  1. Pillai JB, Vegas A, Brister S. Thoracic complications of nasogastric tube: Review of safe practice. Interact Cardiovasc Thorac Surg. 2005; 4::429433.
    [Google Scholar]
  2. Trujillo MH, Fragachan CF, Tortoledo F, Ceballos F. “Lariat loop” knotting of a nasogastric tube: An ounce of prevention. Am J Crit Care. 2006; 15::413414.
    [Google Scholar]
  3. Santhanam V, Margarson M. Removal of self-knotted nasogastric tube: Technical note. Int J Oral Maxillofac Surg. 2008; 37::384385.
    [Google Scholar]
  4. Agarwal A, Gaur A, Sahu D, Singh PK, Pandey CK. Nasogastric tube knotting over the epiglottis: A cause of respiratory distress. Anesth Analg. 2002; 94::16591960.
    [Google Scholar]
  5. Dinsmore RC, Benson JF. Endoscopic removal of a knotted nasogastric tube in the posterior nasopharynx. South Med J. 1999; 92::10051007.
    [Google Scholar]
  6. Dohgomori H, Yamada H, Kadota Y, Kakihana Y, Takehara A, Onomoto M, Yoshimura N. Difficulty in the removal of both nasogastric and endotracheal tubes: Report of a case. J Anesth. 1996; 10::151152.
    [Google Scholar]
  7. Mohsin M, Saleem Mir I, Hanief Beg M, Nazir Shah N, Arjumand Farooq S, Altaf Bachh A, Quadir A. Nasogastric tube knotting with tracheoesophageal fistula - a rare association. Interact Cardiovasc Thorac Surg. 2007; 6::508510.
    [Google Scholar]
  8. Joanna Briggs Institute. Methods for determining the correct nasogastric tube placement after insertion in adults. Best Pract Evidence-Based Inf Sheets Health Prof. 2010; 14:1:14.
    [Google Scholar]
  9. Hanna G. Improving the safety of nasogastric feeding tube insertion. Developing guidelines for the safe verification of feeding tube position-a decision analysis approach. A report for the NHS Patient Safety Research Portfolio, July 2010. Available online at: http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/cfhep/psrp/finalreports/PS048ImprovingthesafetyofnasogastricfeedingtubeinsertionREVISEDHannaetal.pdf .

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  • Article Type: Case Report
Keyword(s): knot; nasopharynx and nasogastric tube
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