{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:29Z","timestamp":1756339469542,"version":"3.44.0"},"reference-count":4,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,26]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>A 74-year-old man presented with acute small bowel obstruction secondary to recurrence of a caecal tumour. The patient underwent laparotomy and formation of loop ileostomy and had a nasogastric tube (NGT) inserted in the theatre. A decision was made to remove the patient\u2019s NGT postoperatively, which was found to be stuck. High-quality imaging demonstrated a knot in the tube within the nasopharynx; so, subsequent removal via the oral route necessitated sedation. This case highlights the importance of considering rare or unusual complications of NGT insertion when a patient describes more pain or discomfort than would otherwise be expected. The clarity of imaging highlights clearly the underlying findings when compared with the few other documented cases. We offer a number of learning points specific to this complication.<\/jats:p>","DOI":"10.1136\/bcr-2020-238213","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T17:01:50Z","timestamp":1603990910000},"page":"e238213","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Challenging removal of a knotted nasogastric tube following insertion under general anaesthetic"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3519-8064","authenticated-orcid":false,"given":"Michael","family":"Conroy","sequence":"first","affiliation":[{"name":"Urology, Medway Maritime Hospital, Gillingham, UK"},{"name":"General Surgery, Worthing Hospital, Worthing, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Wichmann","sequence":"additional","affiliation":[{"name":"General Surgery, Worthing Hospital, Worthing, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Farkas","sequence":"additional","affiliation":[{"name":"General Surgery, Worthing Hospital, Worthing, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Di-Nicola","sequence":"additional","affiliation":[{"name":"General Surgery, Worthing Hospital, Worthing, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"2025082707373572000_13.10.e238213.1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.ijom.2007.11.020","article-title":"Removal of self-knotted nasogastric tube: technical note","volume":"37","author":"Santhanam","year":"2008","journal-title":"Int J Oral Maxillofac Surg"},{"key":"2025082707373572000_13.10.e238213.2","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2005.109488"},{"key":"2025082707373572000_13.10.e238213.3","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1002\/lary.23990","article-title":"Preventing nasogastric tube injury: is there a better way?","volume":"123","author":"Ostedgaard","year":"2013","journal-title":"Laryngoscope"},{"key":"2025082707373572000_13.10.e238213.4","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.84175"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238213","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:37:43Z","timestamp":1756305463000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":4,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10,29]]},"published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1136\/bcr-2020-238213"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238213","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}