Unilateral variant of nasogastric tube syndrome in a patient with stroke: A case report

Abstract

Nasogastric tube (NGT) is often used in the early stages of stroke for nutritional support. Nasogastric tube syndrome (NGTS) is a rare but a life-threatening disorder characterized by the triad of NGT insertion, throat pain and vocal cord palsy. A 67-year-old man was admitted for right basal ganglia and intraventricular hemorrhage. He had a history of diabetes mellitus and hypertension. After stereotactic cranial aspiration, NGT feeding was started. At 11 weeks after NGT intubation, he presented with an ambiguous sore throat and stridor. Right posterior cricoarytenoid inflammation and ipsilateral vocal cord palsy was identified through neck computed tomography (CT). Removal of the NGT, endotracheal intubation and intravenous ceftriaxone administration were performed. His symptoms resolved completely and did not recur until discharge. NGTS should be evaluated early in stroke patients with NGTs who present with sore throat and stridor. Increased awareness and early diagnosis of NGTS are important for appropriate management and prevention of progression to fatal clinical outcome.