Iatrogenic intramural esophageal dissection secondary to insertion of nasogastric tubes and the transorally inserted anvil during robot-assisted total gastrectomy

Submucosal Tunnel Formation as a Complication Caused by Long Intestinal Tube Insertion: A Case Report

“…Submucosal tunnel formation (or dissection or bridge formation) is a very rare complication of LIT insertion, and its frequency is unknown [3][4][5][6][7]. In our hospital, where more than 800 cases of LIT insertion have been performed during the past 20 years, this was the first case in which the formation of a submucosal tunnel due to the insertion of the LIT was confirmed.…”

“…Long intestinal tube (LIT) decompression is a useful treatment for patients with bowel obstruction, achieved by draining the intestinal contents [1,2]. While gastrointestinal bleeding, perforation, laryngeal injury, and aspiration pneumonia are well-known complications of LIT insertion, submucosal tunnel formation is a very rare complication [3][4][5][6][7]. We report a case of asymptomatic submucosal tunnel formation attributed to LIT insertion that was incidentally detected through an endoscopy.…”

Chest Pain After Endovascular Aortic Intervention Due to Esophageal Intramural Dissection

“…Intramural esophageal dissection secondary to nasogastric tube insertion is extremely rare, with only 5 reported cases worldwide (Table 1). [2][3][4][5][6] Tashiro et al 2 reported esophageal dissection in a patient in whom a nasogastric tube was inserted after endoscopic hemostasis with clipping of duodenal ulcers. Yang et al 3 reported a patient who drank an agricultural chemical in a suicide attempt and was treated with gastric lavage with charcoal via a standard nasogastric tube.…”

“…EGD was later arranged for odynophagia and showed that the nasogastric tube had been inserted beneath the mucosa from the upper esophagus to the gastric cardia, creating a submucosal tunnel of nearly the whole length of the esophagus. Cho et al 4 reported a case of nasogastric tube trauma causing intramural esophageal dissection 15 cm from the incisor beyond the upper esophageal sphincter at the level of the cricopharyngeus muscle. Hutchinson et al 5 reported a patient with bolus impaction in the esophagus, and a dissecting hematoma was diagnosed on a chest radiograph used to confirm nasogastric tube position.…”

Unusual Shape of Esophageal Stricture After Use of Nasogastric Tube

“…Forced and repeated tube insertions are considered to contribute to the occurrence of tuberelated esophageal injury. 1 The mainstay of treatment for a benign esophageal stricture is endoscopic balloon dilation or cutting dilation. 2 However, these procedures have a substantial risk of complications.…”