title: Severe epistaxis after nasogastric tube insertion requiring arterial embolisation.
abstract: A 53-year-old dialysis patient was admitted with symptoms of a respiratory tract infection, abdominal pain and vomiting. She aspirated and required intubation. A nasogastric tube was placed with slight difficulty and the patient developed severe epistaxis. The bleeding could not be controlled with mechanical pressure and nasal packing. Angiography revealed extravasation from a pseudoaneurysm arising from the inferior pharyngeal branch of the ascending pharyngeal trunk. The vessel was successfully embolised with cessation of bleeding. We emphasise that even a seemingly easy procedure like insertion of a nasogastric tube, can lead to a life-threatening complication.
authors: Department of Medicine,  Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center, Brooklyn, New York,  USA.
authors: Vishesh
authors: V
authors: Paul
authors: Yizhak
authors: Y
authors: Kupfer
authors: Sidney
authors: S
authors: Tessler
mesh_terms: D017541:Aneurysm, False / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000792:Angiography; D001158:Arteries; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods*; D004844:Epistaxis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008875:Middle Aged; D010614:Pharynx / Q000098:blood supply*