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July 5, 1985

Complications of Nasoenteric Tubes

JAMA. 1985;254(1):54. doi:10.1001/jama.1985.03360010060012

To the Editor.—  In the article entitled "Pneumothorax as a Complication of Placement of a Nasoenteric Tube,1" the authors suggested that a roentgenogram of the chest should be obtained to confirm the precise location of the nasoenteric tube, presumably to avoid initiation of tube feeding in cases involving perforation of the lung with resultant intrapleural instillation of fluid. The authors correctly considered that most of the misplaced tubes would indeed follow the usual path of entering into the right mainstem bronchus and, if a stiffening tube were used, perforation into the right pleural cavity would result. However, in occasional cases the misplacement and malpositioning may follow the left mainstem bronchus and then the nasoenteric tube, as visualized by a roentgenogram, will appear to be in the correct position, when, in fact, it is retrocardiac and in the posterior diaphragmatic sulcus rather than in the stomach.I agree that aspiration