A case of fatal internal jugular vein perforation during nasogastric tube insertion
| Autor: | Katherine Smith, Andrew A Taitano, Jeffrey P Fleming, Robert D Bennett |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Insufflation
medicine.medical_specialty Abdominal pain business.industry Exploratory laparotomy medicine.medical_treatment Perforation (oil well) Case Report 030208 emergency & critical care medicine Abdominal distension medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Pneumoperitoneum 030202 anesthesiology Anesthesia medicine Intubation medicine.symptom business Internal jugular vein |
| Zdroj: | Journal of Surgical Case Reports |
| ISSN: | 2042-8812 |
| DOI: | 10.1093/jscr/rjx128 |
| Popis: | Nasogastric tube (NGT) insertion is a routine procedure in the management of surgical patients. We report the second case of internal jugular vein perforation during NGT insertion. A 79-year-old man presented with diffuse abdominal pain secondary to a perforated viscus. Abdominal CT revealed pneumoperitoneum, necessitating emergent exploratory laparotomy. On post-operative Day 7, the patient developed mild abdominal distension and subjective nausea for which NGT placement was ordered for decompression. Tube placement was confirmed by insufflation of air without aspiration of gastric contents. Output from the NGT upon placement revealed frank blood. The patient then developed respiratory distress requiring intubation, followed by a fatal arrhythmia. Post-mortem exam revealed the trajectory of the NGT through the pharyngeal wall into the right internal jugular vein. This case illustrates the importance of systematic evaluation of all procedures, as the outcome resulted from failure to recognize the initial error in tube placement. |
| Databáze: | OpenAIRE |
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