Occurrence of a pneumothorax secondary to malpositioned nasogastric tube: a case report

We report on the case of a 79-year-old man undergoing a Whipple operation with postoperative unstable respiratory status. Non-invasive ventilation therapy was started and a nasogastric tube (NGT) was placed to lower the risk of gastric accumulation of air. The NGT was placed following recommended clinical procedures. For further examination of the respiratory status, an X-ray was done, which presented the NGT entering the bronchial tree, following the main bronchus down and a newly occurring pneumothorax in the right lung. The NGT was removed immediately and the pneumothorax was treated by drainage of the pleura. Bronchoscopy showed no evidence of tracheobronchial injury. Antibiotic therapy was strated and the patient made a full recovery. This case report should remind medical staff of the potential risk of placing of NGT, and gives advice for proper placement to improve patient safety.