Misplaced catheter

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Misplaced nasogastric tube

Inadvertent Intracranial Placement of a Nasogastric Tube in a Patient With Severe Craniofacial Trauma

  • 35 cases of intracranial nasogastric tube insertion have been reported in the international literature. [1] [2]
  • A complex craniofacial fracture is the most common predisposing factor.
  • Complications include hemiparesis, intracranial bleeding, decerebrate posturing, respiratory arrest, suctioning of brain parenchyma, blindness, loss of the sense of smell, meningitis, decreased mental status, and persistent cerebrospinal fluid fistula.
  • Mortality rate of 64%.

Images courtesy of RadsWiki

Inadvertent Intracranial Placement of a Nasogastric Tube in a Patient With Severe Craniofacial Trauma


Inadvertent Intracranial Placement of a Nasogastric Tube in a Patient With Severe Craniofacial Trauma


Inadvertent Intracranial Placement of a Nasogastric Tube in a Patient With Severe Craniofacial Trauma


Inadvertent Intracranial Placement of a Nasogastric Tube in a Patient With Severe Craniofacial Trauma


Misplaced endotracheal tube

  • What happens if the endotracheal tube is too high?
    • Endotracheal tube can rub against the vocal cords and cause cord trauma.
  • What happens if the endotracheal tube is too low?
    • Endotracheal tube can selectively intubate the right or left mainstem bronchus.
  • Esophagus can also be intubated
    • Suspect esophageal intubation when there is progressive gaseous distention of the stomach while the lung volumes remain low.

Images courtesy of RadsWiki

No left breath sounds post intubation: ETT in right mainstem bronchus


ETT pulled back and now in good position


Esophageal intubation


Misplaced central lines (CVP catheters)

PICC from left superior vena cava to coronary sinus to right atrium to inferior vena cava to left hepatic vein

Image courtesy of RadsWiki


Coiled in Axillary

Images courtesy of RadsWiki



Misplaced umbilical venous catheters

UVC through PFO

Image courtesy of RadsWiki


UVC in SMV

Image courtesy of RadsWiki


Misplaced Foley catheter

A patient with suprapubic pain after the Foley catheter insertion

Images courtesy of RadsWiki

Misplaced Foley catheter (The catheter placed into patients uterus)


Misplaced Foley catheter (The catheter placed into patients uterus)


Misplaced gastrostomy tube

A gastrostomy tube in the liver

A gastrostomy tube in the liver

A gastrostomy tube in the liver

References

  1. Journal of Oral and Maxillofacial Surgery - http://www.sciencedirect.com/science/journal/02782391
  2. Paloma Rodrigues Genú, David Moraes de Oliveira, Ricardo José de Holanda Vasconcellos, Ricardo Viana Bessa Nogueira and Belmiro Cavalcanti do Egito Vasconcelos. Inadvertent intracranial placement of a nasogastric tube in a patient with severe craniofacial trauma: A case report. Journal of Oral and Maxillofacial Surgery. 2004. 62: 1435-1438.


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