Pneumothorax Complicating Small-Bore Feeding Tube Placement

doi:10.1001/archinte.1991.00400030129025

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Vol. 151 No. 3, MARCH 1991

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Pneumothorax Complicating Small-Bore Feeding Tube Placement

Gary D. Wendell, MD; Gregory S. Lenchner, MD; Robert A. Promisloff, DO

Arch Intern Med. 1991;151(3):599-602.

Abstract

Small-bore Silastic feeding tubes are being used with increasingfrequency for short- and long-term enteral hyperalimentation.We present three cases where these flexible tubes were passedinto the tracheobronchial tree and then out into the pleuralspace. The result in each case was a pneumothorax or hydropneumothorax.These cases were collected at one community hospital over a6-month period. A review of the current literature reveals reportsof 10 similar cases. We conclude that, although the exact incidenceof pleural complications of small-bore feeding tubes is unknown,it is not insignificant. The traditional methods of assessingproper nasogastric tube placement are inadequate when appliedto these small tubes. Only a chest roentgenogram can assureplacement in the stomach. Education of hospital staff on methodsto avoid malposition of feeding tubes has resulted in an absenceof pulmonary complications over a subsequent 1-year period.

(Arch Intern Med. 1991;151:599-602)

Author Affiliations

From the Division of Pulmonary Diseases, Hahnemann University Hospital, Philadelphia, Pa.

Footnotes

Accepted for publication October 4, 1989.

Reprint requests to Division of Pulmonary Diseases, HahnemannUniversity Hospital, Broad and Vine Streets, Philadelphia, PA19102-1192 (Dr Promisloff).

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