Abstract
A 4-week-old, ASA 1, boy is scheduled for a pyloromyotomy. Prior to anesthesia his nasogastric tube (NGT) is removed. The anesthesia induction and maintenance is uneventful. A new NGT is easily inserted during surgery (Argyle feeding tube, Sherwood Medical, size Ch 8, external diameter 2.7 mm × 107 cm). Its correct position is verified by air insufflations through the NTG and observing a slight dilation of the stomach [1]. The patient is taken to the pediatric ICU for recovery. Several hours later, the nurse attempts to manipulate the NGT since it seems to be occluded. While she is attempting to move the NGT, she is surprised to see a loop of the NGT suddenly appear in the mouth. She pushes the NGT in again but after that she cannot move the NGT up or down. You are called and confirm that the NGT is stuck. Using your index finger you examine the baby’s mouth but have difficulty ascertaining what is going on.
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