Education: Images in Anesthesiology  |   October 2016
Images in Anesthesiology: Bronchopleural Fistula Caused by the Incorrect Placement of the Enteral Feeding Tube
Author Notes
  • From the Istituto Anestesia e Rianimazione, Azienda Ospedaliera di Padova, Padova, Italy (E.S., A.B., S.R.); and Unità Operativa di Radiologia, Azienda Ospedaliera di Padova, Padova, Italy (R.V.).
  • Address correspondence to Dr. Saraceni: betta.saraceni@gmail.com
Article Information
Education / Images in Anesthesiology / Respiratory System
Education: Images in Anesthesiology   |   October 2016
Images in Anesthesiology: Bronchopleural Fistula Caused by the Incorrect Placement of the Enteral Feeding Tube
Anesthesiology 10 2016, Vol.125, 805. doi:10.1097/ALN.0000000000001137
Anesthesiology 10 2016, Vol.125, 805. doi:10.1097/ALN.0000000000001137
THE positioning of a nasoenteric feeding tube (NET) in critically ill patients is usually considered to be an easy and safe procedure, but it may be the cause of severe complications such as transbronchial intubation, pneumonia, esophageal perforation, pneumothorax, pulmonary hemorrhage, and intracranial placement.1 
Computed tomography scans without contrast (fig. A and B) describe a tracheobronchial insertion of the NET, complicated by a bronchopleural fistula. A multiplanar reconstruction image (fig. A) shows the NET advancing beyond the tracheostomy tube into the right inferior bronchus (thin arrow) and an associated moderate right pleural effusion (big arrow). A volume rendering technique image (fig. B) highlights the aerated lungs (pink areas) and shows the NET penetrating through the lung, with its tip reaching the pleural space into the costophrenic recess (white arrow).
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