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East and Central African Journal of Surgery

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Nasogastric Tube Knotting: Two Case Reports from Kampala, Uganda

P Ongom, G Nassali, S Kaggwa, L Nakavuma

Abstract


Background: Nasogastric tube (NGT) use is common in patients’ care right from basic health units to tertiary hospitals. NGT knotting is a very rare complications associated with its insertion. In this review, we present two cases of NGT knottingencountered in two cases.
Case Reports: The two cases presented around the same time in two major hospitals in Kampala. One was a 60-year female (Case 1) and another, a 24-year old female (Case 2). Both cases had been admitted with clinical features of small bowel obstruction secondary to adhesions. At surgery, Case 1 had resection and primary anastomosis for a gangrenous loop of ileum. Case 2 was first managed conservatively failing of which she had a laparotomy. As part of their preoperative management, they had a NGTs inserted, while fully conscious. The NGTs functioned well pre-operative, intraoperative
and postoperative. Postoperatively, they both had difficulty NGT removal. Case 1 was a case of “overhand” knotting, while case 2 was a complex, “4-loop”knot, of plastic NGT.
Conclusion: A review of literature reveals that no such cases have been documented from the East African region, and offer lesson for surgeons and gynaecologists. Healthcare providers should be aware of this and complication and how to ‘troubleshoot” the problem.



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