BMJ Case Reports 2017; doi:10.1136/bcr-2017-220287
  • Reminder of important clinical lesson

Nasogastric tube knotting: a rare and potentially overlooked complication among healthcare professionals

  1. Saleem El-Rabaa1
  1. 1Department of General Surgery, Kettering General Hospital NHS Foundation Trust, Kettering, UK
  2. 2Department of Radiology, Kettering General Hospital NHS Foundation Trust, Kettering, UK
  1. Correspondence to Vijay Chavda, vijaycc987{at}
  • Accepted 14 July 2017
  • Published 7 September 2017


Nasogastric tube placement is a common procedure performed in surgical and medical specialities. The occurrence of knot formation is perhaps one of the least well-recognised complications associated with its usage. We present a case of nasogastric tube knotting to remind colleagues of this rare but important complication. A 75-year-old woman with adhesional bowel obstruction was admitted under the general surgery team. A wide bore nasogastric tube was inserted for drainage and decompression. Although placement of the tube was deemed to be successful, there was no drainage of gastric content evident. On removal of the ‘non-functioning’ tube a simple knot was seen at its proximal end. A further nasogastric tube was placed and the patient’s symptoms resolved with conservative management. Nasogastric tube knotting is a rare and often overlooked complication with the potential to cause significant trauma on tube removal if unrecognised.


  • Contributors VC: Senior house officer looking after patient on ward, planning of case report, acquisition of images and patient consent, literature review, write up of article and submission of article. TA : Registrar looking after patient on ward, liaising with radiologist and review of CT images, review of case report and amendments to content/structure. JF: Registrar looking after patient on ward, review of case report and amendments to content/structure. LN: Review of article and amendments to content/structure, reformatting and review of CT images. SE-R: Consultant in charge of patient care, final review and amendments to article.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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