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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 increasing frequency for short- and long-term enteral hyperalimentation. We present three cases where these flexible tubes were passed into the tracheobronchial tree and then out into the pleural space. The result in each case was a pneumothorax or hydropneumothorax. These cases were collected at one community hospital over a 6-month period. A review of the current literature reveals reports of 10 similar cases. We conclude that, although the exact incidence of pleural complications of small-bore feeding tubes is unknown, it is not insignificant. The traditional methods of assessing proper nasogastric tube placement are inadequate when applied to these small tubes. Only a chest roentgenogram can assure placement in the stomach. Education of hospital staff on methods to avoid malposition of feeding tubes has resulted in an absence of 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, Hahnemann University Hospital, Broad and Vine Streets, Philadelphia, PA 19102-1192 (Dr Promisloff).

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