- 期刊
Fatal Massive Hemorrhage Caused by Nasogastric Tube Misplacement in a Patient with Mediastinitis
並列摘要
Nasogastric tube insertion is a routine procedure in medical care. However, misplacement of the tube can cause a variety of complications, which can be life threatening in some instances. We report a case of fatal hemorrhagic shock immediately after nasogastric tube insertion in a patient undergoing debridement by video-assisted thoracoscopic surgery for mediastinitis. Emergency endoscopy showed that the bleeding came from the nasogastric tube which had perforated the esophagus and possibly tore an intrathoracic large vessel. The nasogastric tube insertion was considered to have directly produced the perforation because no esophageal perforation had been found on preoperative endoscopy. Factors contributing to the risk of esophageal perforation in this case included coexisting mediastinitis, surgical manipulation, endotracheal intubation, inability to cooperate during general anesthesia, and repetitive advancement of the nasogastric tube. Prompt clamping of the nasogastric tube or delayed insertion after failed attempts might have improved the outcome. This report illustrates the complication of massive bleeding that can occur immediately after misplaced insertion of a nasogastric tube. Extraordinary care should be taken to avoid misplacement of the nasogastric tube during insertion.
延伸閱讀
- Lin, W. C., Wang, T. E., Wang, C. H., Yang, P. S., & Wang, H. Y. (2014). Hemorrhagic Hepatocellular Adenoma Occurring in a Patient with Hyperaldosteronism. 台灣癌症醫學雜誌, 30(1), 65-69. https://doi.org/10.6323/JoCRP.2014.30.1.9
- Wang, W. H., Chen, Y. C., & Hsieh, M. H. (2019). Acute Myocardial Infarction Involving Left Main Artery in a Patient with Antiphospholipid Syndrome. Acta Cardiologica Sinica, 35(6), 655-658. https://doi.org/10.6515/ACS.201911_35(6).20190829A
- Lin, H. Y. H., Chen, T. C., Chen, Y. H., Lu, P. L., Lin, W. R., & Yang, Y. C. (2008). Hemorrhagic Bullae Caused by Bacteroides fragilis in a Patient with Intra-abdominal Infection. Journal of the Formosan Medical Association, 107(8), 659-662. https://www.airitilibrary.com/Article/Detail?DocID=09296646-200807-107-8-659-662-a
- Tsai, M. H., Yang, Y. C., Wang, K., Chen, V. T., & Chou, S. J. (2006). Serious Hemorrhage Following a Transanal Incisional Biopsy for a Rectal Gastrointestinal Stromal Tumor. 輔仁醫學期刊, 4(4), 209-213. https://www.airitilibrary.com/Article/Detail?DocID=18102093-200612-4-4-209-213-a
- Chung, K. C., Lin, T. C., Hu, S. Y., & Wu, C. C. (2011). Spontaneous Hemoperitoneum Caused by Ruptured Pseudoaneurysm of the Common Hepatic Artery. 台灣急診專科醫師期刊, 3(4), 117-121. https://doi.org/10.29749/JTCEP.201112.0003