To the Editor.–We recently treated a surgical patient in whom a pneumothorax was directly attributable to displacement of a nasogastric tube.
Report of a Case.–The patient, thought to be experiencing alcohol withdrawal, removed the nasogastric tube several times during the early postoperative period. At the time of intubation on the third postoperative day dark fluid was aspirated, and air was propulsed into the tube to ascertain its position.
Several hours later, the patient's physical condition was characterized by agitation, tachypnea, and tachycardia. A chest roentgenogram disclosed a pneumothorax on the right side and a possible displacement of the nasogastric tube into the right pleural space (Figure). A lateral chest roentgenogram disclosed that the nasogastric tube was adjacent to the tracheostomy tube and anterior to the esophagus. A thoracostomy tube was placed for a right pneumothorax. The nasogastric tube, which appeared to be in the right hemithorax, was removed