title: An unusual case of airway obstruction at the tip of an endotracheal tube caused by insertion of a nasogastric tube.
abstract: We report an unusual case of ventilatory impediment caused by the obstruction of an endotracheal tube (ETT) by a nasogastric (NG) tube. A 72-year-old woman with bronchial asthma was scheduled for colostomy closure. An ETT of 7.5-mm internal diameter (ID) could not be advanced, and finally a 5.0-mm ID ETT was placed, because she had post-intubation tracheal stenosis. When an NG tube was inserted after endotracheal intubation, ventilation suddenly became nearly impossible. She was treated for an asthmatic attack, but her respiratory condition did not recover. We then exchanged the ETT for a laryngeal mask airway (LMA) and removed the NG tube. It was suspected that the cause of the airway obstruction was that the NG tube in the esophagus compressed the membranous portion of the stenotic trachea and the tip of the ETT was obstructed.
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Hirakata, Osaka, Japan.
authors.forename: Kozue
authors.initials: K
authors.lastname: Kubo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakao
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Kawabata
authors.forename: Hiroji
authors.initials: H
authors.lastname: Nishimae
authors.forename: Shinya
authors.initials: S
authors.lastname: Masuko
authors.forename: Koh
authors.initials: K
authors.lastname: Shingu
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery; D001249:Asthma / Q000150:complications / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D014135:Tracheal Stenosis / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome