Removal of self-knotted nasogastric tube Technical Note

Spontaneous “lariat loop” knotting of a nasogastric tube: prevention and management

“…1 Factors which predispose to knotting include narrow bore tubes, multiple manipulations during insertion, deep insertion into the stomach, a small stomach following gastroplasty, softening of the tube at body temperature and interference with an endotracheal tube in an intubated patient. 3,4 Knotting can lead to serious complications including respiratory distress, severe laryngeal injury and tracheoesophageal puncture. 3,5 Cases reported earlier have been associated with one or more risk factors.…”

“…1,2 Various provoking factors for knotting have been described. 3,4 We focus on prevention and management of this condition and report a case of spontaneous "lariat loop" knotting of a large bore nasogastric tube in the absence of any provoking factor.…”

“…It has been rarely reported to cause acute pancreatitis. [2][3][4][5][6][7][8] We report a patient with acute necrotizing pancreatitis probably induced by olanzapine and review reports of this rare condition from the literature.…”

Knotted Ryle's Tube: A Rare Complication

“…The predisposing factors for knotting include narrow tube, multiple manipulations during insertion, deep insertion into stomach, and interference with endotracheal tube in an intubated patient. 2,3 Knotting can result in respiratory distress, laryngeal and nasal trauma during removal attempts, and tracheoesophageal perforation. 3,4 Knotting can be prevented by using larger diameter tubes and avoiding excess advancement into the stomach.…”

“…2,3 Knotting can result in respiratory distress, laryngeal and nasal trauma during removal attempts, and tracheoesophageal perforation. 3,4 Knotting can be prevented by using larger diameter tubes and avoiding excess advancement into the stomach. In our patient, the presence of an endotracheal tube was the only risk factor present.…”