Self knotting of Nasogastric tube: an unusual and rare complication

Abstract

Nasogastric tubes are commonly used in daily practice both for stomach decompression and for feeding
purposes however the number of potential complications almost exceeds the indications for use. This
innocent-looking tube can at times cause unexpected complications especially in patients with pre
existing risk factors. It has been found to have led to serious complications including respiratory
distress, severe laryngeal injury, and trachea-esophageal puncture. Knotting of small-bore feeding tubes
and nasogastric tubes during insertion and removal is rare; knotting of large-caliber nasogastric tubes is
even more uncommon. However most of this morbidity is avoidable with careful attention to detail when
placing the tube and careful management of the tube on a day to day basis. A knot occurring in the distal
end of a nasogastric tube is a rare complication. This is either recognized once the tube is completely
removed, or if resistance is encountered during its removal, when the knot presses upon the posterior
aspect of the nasal area. We hereby report a knotted nasogastric tube on one of our long stay patient in
our health facility inserted for feeding and administration of medication. After some time, it was observed
that the nasogastric tube suddenly became blocked. Attempts to flush the tube freely failed.