March 1991

Pneumothorax Complicating Small-Bore Feeding Tube Placement

Author Affiliations

From the Division of Pulmonary Diseases, Hahnemann University Hospital, Philadelphia, Pa.

Arch Intern Med. 1991;151(3):599-602. doi:10.1001/archinte.1991.00400030129025

Small-bore Silastic feeding tubes are being used with increasing frequency for short- and long-term enteral hyperalimentation. We present three cases where these flexible tubes were passed into the tracheobronchial tree and then out into the pleural space. The result in each case was a pneumothorax or hydropneumothorax. These cases were collected at one community hospital over a 6-month period. A review of the current literature reveals reports of 10 similar cases. We conclude that, although the exact incidence of pleural complications of small-bore feeding tubes is unknown, it is not insignificant. The traditional methods of assessing proper nasogastric tube placement are inadequate when applied to these small tubes. Only a chest roentgenogram can assure placement in the stomach. Education of hospital staff on methods to avoid malposition of feeding tubes has resulted in an absence of pulmonary complications over a subsequent 1-year period.

(Arch Intern Med. 1991;151:599-602)