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Delayed gastric perforation following nasogastric tube insertion: the pitfalls of radiographic confirmation
  1. Thomas Wallbridge,
  2. Mahesh Eddula,
  3. Prakash Vadukul and
  4. John Bleasdale
  1. Critical Care Services, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  1. Correspondence to Dr Thomas Wallbridge; thomas.wallbridge{at}


A man in his 70s, admitted to intensive care unit following an out of hospital cardiac arrest, had a nasogastric (NG) tube inserted on admission. Correct placement of the NG tube had been confirmed using National Patient Safety Agency (NPSA) criteria and was used for feeding without incident. He remained intubated and ventilated throughout his stay. On day 9 his oxygen requirements increased with subsequent chest imaging revealing an incidental gastric perforation secondary to NG tube migration. The NG tube was removed intact and undamaged. The patient appeared to improve without sequelae from the perforation or signs of abdominal sepsis. Unfortunately his condition deteriorated due to a large right atrial thrombus and life sustaining treatments were withdrawn.

  • intensive care
  • general surgery
  • gastroenterology

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  • Contributors All authors Wallbridge T, Eddula M, Vadukul P, Bleasdale J, Critical care unit, Sandwell and West Birmingham Hospitals NHS Trust were involved in the patient’s care. TW wrote and compiled the case report. ME, PV, JB and TW were involved in editing and revising subsequent drafts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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