Pneumothorax complicating small-bore feeding tube placement.
Small-bore Silastic feeding tubes are being used with increasing frequency for short- and long-term enteral hyperalimentation. We present three cases where these flexible tubes were passed into the tracheobronchial tree and then out into the pleural space. The result in each case was a pneumothorax or hydropneumothorax. These cases were collected at one community hospital over a 6-month period. A review of the current literature reveals reports of 10 similar cases. We conclude that, although the exact incidence of pleural complications of small-bore feeding tubes is unknown, it is not insignificant. The traditional methods of assessing proper nasogastric tube placement are inadequate when applied to these small tubes. Only a chest roentgenogram can assure placement in the stomach. Education of hospital staff on methods to avoid malposition of feeding tubes has resulted in an absence of pulmonary complications over a subsequent 1-year period.
Wendell
G D
GD
Division of Pulmonary Diseases, Hahnemann University Hospital, Philadelphia, Pa. 19102-1192.
Lenchner
G S
GS
Promisloff
R A
RA
D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D006801:Humans; D006872:Hydropneumothorax / Q000000981:diagnostic imaging / Q000209:etiology; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012826:Silicone Elastomers; D012828:Silicones
D012826:Silicone Elastomers; D012828:Silicones