Advertisement

Does Everyone with a Small Bowel Obstruction Need a Nasogastric Tube? What Is the Safest Way to Place It?

  • Ashley Gray
  • Jessica L. Smith
Chapter

Abstract

Nasogastric (NG) intubation is a common practice in conservative management of small bowel obstruction. When indicated, it can provide patients symptomatic relief and lead to improved measurement of gastrointestinal losses, allowing for adequate fluid repletion. However, NG tubes have been associated with increased respiratory failure in patients without emesis and carry significant risks if malpositioned or used for a prolonged duration. NG tubes are generally warranted in symptomatic patients but should be considered on a case-by-case basis for asymptomatic patients.

Keywords

Small bowel obstruction Intestinal decompression Nasogastric tube Nasointestinal tube Aspiration pneumonia Respiratory failure 

References

  1. 1.
    Jackson P, Raiji M. Evaluation and management of intestinal obstruction. Am Fam Physician. 2011;83(2):159–65.PubMedGoogle Scholar
  2. 2.
    Maung A, Johnson D, Piper G, Barbosa R, Rowell S, Bokhari F, et al. Evaluation and management of small-bowel obstruction. J Trauma Acute Care Surg. 2012;73:S362–9.CrossRefGoogle Scholar
  3. 3.
    Diaz JJ Jr, Bokhari F, Mowery NT, Acosta JA, Block EF, Bromberg WJ, Collier BR, Cullinane DC, Dwyer KM, Griffen MM, Mayberry JC, Jerome R. Guidelines for management of small bowel obstruction. J Trauma. 2008;64(6):1651–64.CrossRefGoogle Scholar
  4. 4.
    Keenan J, Turley R, McCoy C, Migaly J, Shapiro M, Scarborough J. Trials of nonoperative management exceeding 3 days are associated with increased morbidity in patients undergoing surgery for uncomplicated adhesive small bowel obstruction. J Trauma Acute Care Surg. 2014;76(6):1367–72.CrossRefGoogle Scholar
  5. 5.
    Overview of management of mechanical small bowel obstruction in adults [internet]. 2017 [cited 31 August 2017]. Available from: https://www.uptodate.com/contents/overview-of-management-of-mechanical-small-bowel-obstruction-in-adults?source=search_result&search=sbo&selectedTitle=1~150
  6. 6.
    Fonseca A, Schuster K, Maung A, Kaplan L, Davis K. Routine nasogastric decompression in small bowel obstruction: is it really necessary? Am Surg. 2013;79:422–8.PubMedGoogle Scholar
  7. 7.
    Nasogastric and nasoenteric tubes [internet]. 2017 [cited 31 August 2017]. Available from: https://www.uptodate.com/contents/nasogastric-and-nasoenteric-tubes?source=search_result&search=ngt&selectedTitle=1~150
  8. 8.
    Nickson C. Nasogastric and orogastric tubes [internet]. 2017 [cited 31 August 2017]. Available from: https://lifeinthefastlane.com/ccc/nasogastric-tube-insertion/
  9. 9.
    Wang P, Tseng G, Yang H, Chou K, Chen C. Inadvertent tracheobronchial placement of feeding tube in a mechanically ventilated patient. J Chin Med Assoc. 2008;71(7):365–7.CrossRefGoogle Scholar
  10. 10.
    Pillai J, Vegas A, Brister S. Thoracic complications of nasogastric tube: review of safe practice. Interact Cardiovasc Thorac Surg. 2005;4(5):429–33.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ashley Gray
    • 1
  • Jessica L. Smith
    • 1
  1. 1.Department of Emergency MedicineAlpert Medical School of Brown UniversityProvidenceUSA

Personalised recommendations