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Unexpected outcome (positive or negative) including adverse drug reactions
Severe epistaxis after nasogastric tube insertion requiring arterial embolisation
  1. Vishesh Paul,
  2. Yizhak Kupfer,
  3. Sidney Tessler
  1. Department of Medicine, Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Sidney Tessler, stessler{at}


A 53-year-old dialysis patient was admitted with symptoms of a respiratory tract infection, abdominal pain and vomiting. She aspirated and required intubation. A nasogastric tube was placed with slight difficulty and the patient developed severe epistaxis. The bleeding could not be controlled with mechanical pressure and nasal packing. Angiography revealed extravasation from a pseudoaneurysm arising from the inferior pharyngeal branch of the ascending pharyngeal trunk. The vessel was successfully embolised with cessation of bleeding. We emphasise that even a seemingly easy procedure like insertion of a nasogastric tube, can lead to a life-threatening complication.

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