Pulmonary aspiration complicating intraoperative small-bowel decompression: a case report and literature review.
When conservative management of intestinal obstruction fails, the surgeon has two operative choices for decompression: the open procedure with enterotomies and suction and the closed procedure consisting of retrograde stripping and nasogastric suction. A previously undocumented complication of the latter procedure-pulmonary aspiration-is reported in a 20-year-old man with small-bowel obstruction. Practical modifications to the technique of small-bowel decompression are suggested. They include feeding the nasogastric tube into the distal duodenum, using a wider bore tube, inserting an esophageal balloon before extubation, using a nasogastric tube with suction throughout extubation and, immediately postoperatively, making a more conscious effort to remove all gastric contents before extubation, and milking the contents distally through the ileocecal valve.
Phillips
I
I
Department of Surgery, University Hospital, University of Toronto, Ont.
Jamieson
C G
CG
D000328:Adult; D003664:Decompression / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007421:Intestine, Small / Q000033:anatomy & histology / Q000601:surgery; D007431:Intraoperative Complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011015:Pneumonia, Aspiration / Q000628:therapy*