Bilateral Pneumothoraces During Nasogastric Tube Placement: A Case Report

Nasogastric tube (NGT) insertion is common in inpatient and critical care management. Though NGT and nasoenteric tube insertions provide additional options for enteric feeding or medication administration, they are not without risk. Respiratory complications, especially pneumothorax, are a recurrent concern, especially with blind placement of NGTs. In the presented case, a tracheostomized patient admitted for meningitis underwent blind insertion of an NGT which resulted in bilateral pneumothoraces, diagnosed by chest X‐ray and managed successfully with chest tubes. This patient’s unfortunate experience highlights the necessity of safer methods of NGT placement. Review of the literature showed multiple promising alternatives to blind placement, including simultaneous capnographic monitoring, dual‐stage insertion with doubled X‐ray confirmation, or direct visualization via GlideScope (a form of video laryngoscopy). Although these methods require additional training, time, and supplies, the risk of complications of blind insertion outweighs these barriers.