{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:31:05Z","timestamp":1786728665609,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Nasogastric tube (NGT) insertion is a common procedure, often performed blindly. We report a rare, near-fatal complication in a 44-year-old woman where an NGT traversed the internal jugular vein, superior vena cava, and perforated the right atrium into the pericardial cavity. Prompt imaging and surgical retrieval via sternotomy prevented tamponade or exsanguination. No esophageal injury was found; the likely entry point was the nasopharynx. A sealed duodenal perforation was managed conservatively. This case emphasizes the importance of verifying NGT placement before use and the role of confirmatory X-ray.<\/jats:p>","DOI":"10.4103\/aca.aca_211_25","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T16:00:41Z","timestamp":1768579241000},"page":"132-135","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Potentially Lethal Course of a Nasogastric Tube: Case Report"],"prefix":"10.4103","volume":"29","author":[{"given":"G. J","family":"Lekshmipriya","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Aster Medcity, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George V.","family":"Kurien","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Aster Medcity, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh G.","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Aster Medcity, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Rajmohan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Aster Medcity, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupama","family":"Shaji","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Aster Medcity, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"R1-20260331","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/MOG.0b013e3280287a0f","article-title":"Complications related to feeding tube placement","volume":"23","author":"Metheny","year":"2007","journal-title":"Curr Opin Gastroenterol"},{"key":"R2-20260331","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1213\/00000539-200206000-00056","article-title":"Nasogastric Tube knotting over the epiglottis: A cause of respiratory distress","volume":"94","author":"Agarwal","year":"2002","journal-title":"Anesth Analg"},{"key":"R3-20260331","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1080\/02688699943547","article-title":"Intracranial malposition of a nasogastric tube following repair of choanal atresia","volume":"13","author":"Nathoo","year":"1999","journal-title":"Br J Neurosurg"},{"key":"R4-20260331","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1001\/archinte.1989.00390010156022","article-title":"Pneumothorax due to nasogastric feeding tubes. Report of four cases, review of the literature, and recommendations for prevention","volume":"149","author":"Roubenoff","year":"1989","journal-title":"Arch Intern Med"},{"key":"R5-20260331","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1007\/s00247-006-0258-3","article-title":"Pericardial sac perforation: A rare complication of neonatal nasogastric tube feeding","volume":"36","author":"Hanafy","year":"2006","journal-title":"Pediatr Radiol"},{"key":"R6-20260331","first-page":"147","article-title":"Unusual complication of nasogastric esophageal intubation-erosion into an aberrant right subclavian artery","volume":"18","author":"Merchant","year":"1977","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"R7-20260331","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00000542-199807000-00031","article-title":"Accidental intravascular placement of a feeding tube","volume":"89","author":"D\u00fcthorn","year":"1998","journal-title":"Anesthesiology"},{"key":"R8-20260331","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjx128","article-title":"A case of fatal internal jugular vein perforation during nasogastric tube insertion","volume":"2017","author":"Smith","year":"2017","journal-title":"J Surg Case Rep"},{"key":"R9-20260331","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1186\/s13054-023-04611-6","article-title":"Nasogastric tube insertion length measurement and tip verification in adults: A narrative review","volume":"27","author":"Boeykens","year":"2023","journal-title":"Crit Care"},{"key":"R10-20260331","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1510\/icvts.2005.109488","article-title":"Thoracic complications of nasogastric tube: Review of safe practice","volume":"4","author":"Pillai","year":"2005","journal-title":"Interact Cardiovasc Thorac Surg"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_211_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:30:05Z","timestamp":1786725005000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_211_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_211_25","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-08-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}