Entrapment of a long dwelling nasogastric tube after radiotherapy in an oral cancer patient: a rare case report

Abstract

The use of a nasogastric (NG) tube forms a part of the daily routine after surgery for oral cancer, and is vital for enteral feeding of the patient. However, the use of NG tubes is not without complications, which include tube obstruction, tube breakage, tube double backing, and kinking. NG entrapment, which is seen in bariatric and other gastrointestinal surgeries when the tube is caught in the staple line, is rarely seen in postoperative patients with oral cancer due to the long dwelling of the tube and the adjuvant radiotherapy. A 55-year-old man presented after 3 months of surgery for oral cancer and having completed adjuvant radiotherapy with a blocked and stuck nasogastric tube. After the endoscopic removal of the tube failed twice, the NG tube was removed by performing a gastrostomy via the midline mini laparotomy approach. Frequent monitoring, changing of NG tube and continual re-review of indications for continued use of feeding tubes is prudent, including consideration of changing goals of care. Educating the patient and his relatives/care takers at the time of the discharge with the instructions of care will surely help to prevent such a complication.