PMID- 34909329
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211217
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 11
DP  - 2021 Nov
TI  - Delayed Adult Gastric Perforation Following Insertion of a Feeding Nasogastric 
      Tube.
PG  - e19411
LID - 10.7759/cureus.19411 [doi]
LID - e19411
AB  - Although complications of a nasogastric tube (NGT) are identified and managed in 
      daily clinical practice, gastric perforation following NGT insertion is a serious 
      and rarely reported condition in adults. We present a case of a 71-year-old male 
      who was brought to the hospital after having a cardiac arrest. Following 
      stabilisation and receiving an emergency percutaneous coronary intervention 
      (PCI), he was admitted to the intensive care unit (ICU), where he required NGT 
      for feeding purposes. A few days later, abdominal distension was noted, and chest 
      imaging was requested mainly for worsening respiratory parameters. A computed 
      tomography (CT) scan confirmed gastric perforation and a misplaced NGT. Being a 
      high-risk patient and in the absence of peritonism and frank sepsis, conservative 
      management was adopted and included proton pump inhibitors (PPI), total 
      parenteral nutrition (TPN), stomach aspiration via a Ryle tube and consideration 
      of imaging-guided drainage. No risk factor for gastric perforation was identified 
      in this presented case. The stable course of follow-up suggested sealed 
      perforation; however, he died due to an extensive intracardiac thrombus. Though 
      this incidence did not contribute directly to the patient's death, it definitely 
      added to the overall morbidity and negatively influenced the management of the 
      other medical conditions. For complement, we also report a review of the ten 
      similar cases in the literature, highlighting the associated risk factors, 
      relevant clinical challenges, lines of management executed. The main aim of this 
      case report is to enhance doctors' awareness of this serious complication, 
      especially in patients with risk factors, and its diagnostic dilemmas. Early 
      recognition and prompt intervention are recommended for a better outcome.
CI  - Copyright (c) 2021, Albendary et al.
FAU - Albendary, Mohamed
AU  - Albendary M
AD  - Department of General Surgery, Sandwell and West Birmingham National Health 
      Services (NHS) Trust, Birmingham, GBR.
FAU - Mohamedahmed, Ali Yasen Y
AU  - Mohamedahmed AYY
AD  - Department of General Surgery, Sandwell and West Birmingham National Health 
      Services (NHS) Trust, Birmingham, GBR.
FAU - George, Anil
AU  - George A
AD  - Department of General Surgery, Sandwell and West Birmingham National Health 
      Services (NHS) Trust, Birmingham, GBR.
LA  - eng
PT  - Case Reports
DEP - 20211109
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8660065
OTO - NOTNLM
OT  - adult
OT  - delayed perforation
OT  - feeding nasogastric tube
OT  - gastric perforation
OT  - nasogastric tube complications
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/12/16 06:00
MHDA- 2021/12/16 06:01
PMCR- 2021/11/09
CRDT- 2021/12/15 12:30
PHST- 2021/11/08 00:00 [accepted]
PHST- 2021/12/15 12:30 [entrez]
PHST- 2021/12/16 06:00 [pubmed]
PHST- 2021/12/16 06:01 [medline]
PHST- 2021/11/09 00:00 [pmc-release]
AID - 10.7759/cureus.19411 [doi]
PST - epublish
SO  - Cureus. 2021 Nov 9;13(11):e19411. doi: 10.7759/cureus.19411. eCollection 2021 
      Nov.