Avoidance of Laryngeal Injuries during Gastric Intubation

Abstract

Gastric intubation is a common and simple procedure that is often performed on patients who are sedated or anaesthetised. If the gastric tube (GT) is inserted blindly while the patient is unconscious, this procedure may result in easily preventable complications such as laryngeal trauma. We present an interesting case where the blind placement of a orogastric tube (OGT) in an anesthetised 52-year-old female patient at Sultan Qaboos University Hospital in Oman resulted in significant arytenoid trauma. This led to delayed tracheal extubation. The movement of the GT from the oropharyngeal area to the upper oesophageal sphincter can be visualised and controlled with the use of Magill forceps and a laryngoscope. Therefore, this report highlights the need for GT insertion procedures to be performed under direct vision in patients who are unconscious (due to sedation, anaesthesia or an inherent condition) in order to prevent trauma to the laryngeal structures.

Keywords: Case Report; Gastrointestinal Intubation; Laryngoscopy, complications; Oman.

Figure 1:

An arytenoid oedema with normal vocal cords.

Figure 2:

Superficial erosion of the patient’s upper oesophagus.

Figure 3:

A small gastric ulcer with an adherent clot.