Severe epistaxis after nasogastric tube insertion requiring arterial embolisation
Abstract
A 53-year-old dialysis patient was admitted with symptoms of a respiratory tract infection, abdominal pain and vomiting. She aspirated and required intubation. A nasogastric tube was placed with slight difficulty and the patient developed severe epistaxis. The bleeding could not be controlled with mechanical pressure and nasal packing. Angiography revealed extravasation from a pseudoaneurysm arising from the inferior pharyngeal branch of the ascending pharyngeal trunk. The vessel was successfully embolised with cessation of bleeding. We emphasise that even a seemingly easy procedure like insertion of a nasogastric tube, can lead to a life-threatening complication.
Footnotes
Competing interests: None.
Patient consent: Obtained.
Provenance and peer review: Not commissioned; externally peer reviewed.
References
- 1. Baskin WN. Acute complications associated with bedside placement of feeding tubes. Nutr Clin Pract 2006;21:40–55 [[PubMed]
- 2. Hacein-Bey L, Daniels DL, Ulmer JL, et al The ascending pharyngeal artery: branches, anastomoses, and clinical significance. AJNR 2002;23:1246–56 [[PubMed][Google Scholar]
- 3. Willems PWA, Farba RI, Agida R. Endovascular treatment of epistaxis. AJNR 2009;30:1637–45 [[PubMed]