Iatrogenic Tension Pneumothorax Following Nasogastric Tube Withdrawal

Abstract

Nasogastric tube (NGT) insertion is a simple procedure and generally uneventful. However, complication due to NGT misplacement ranges from tracheobronchial injury, pleural effusion, to a more catastrophic outcome like Tension pneumothorax. This case report represents a tension pneumothorax following nasogastric tube withdrawal.
 A Female patient 67-year-old known case of Hypertension and heart failure was recently diagnosed with buccal Squamous cell carcinoma (SCC) and scheduled for an elective mandibulectomy. Post-operatively patient was admitted to the surgical Intensive care unit (SICU). NGT was inserted. A chest X-ray shows a nasogastric tube mistakenly inserted into the right lung, which led to concealed pleural perforation. Upon withdrawal of the NGT, the patient suddenly became hypoxic and hypotensive and unfortunately developed tension pneumothorax.