Would you feed this patient?
Nasogastric feeding can have serious complications
A 72 year old man with a history of chronic obstructive pulmonary disease, hypertension, and chronic alcohol abuse attended an accident and emergency department with respiratory distress, stridor, and dysphagia. On arrival he had an emergency tracheostomy for his airways obstruction. Initial investigations with nasoendoscopy and computed tomography showed a subglottic mass, which was later confirmed as an advanced laryngeal squamous cell carcinoma. Unfortunately, he was unsuitable for surgical intervention and was given palliative care only. He required a nasogastric tube for feeding. The figure shows a chest radiograph taken during his first week on the ward.
(1) What are the radiographic findings?
(2) Would you start nasogastric feeding in this patient after reviewing the chest radiograph?
(3) What are the potential complications of feeding via this nasogastric tube?
(4) What methods are used to confirm the position of a nasogastric tube?