Difficult tracheostomy decannulation related to nasogastric tube syndrome: A case report

A 65-year-old woman with cervical spine stenosis and spinal cord injury required a tracheostomy due to airway issues during anesthesia. She also needed a nasogastric tube (NGT) for feeding. Later, doctors had trouble removing the tracheostomy tube because of airway swelling. The swelling was likely caused by 'nasogastric tube syndrome' (NGTS), a rare complication where the NGT irritates the throat. Removing the NGT helped reduce the swelling, and the tracheostomy tube was eventually removed successfully. This case highlights that doctors should consider NGTS when patients with both tracheostomies and NGTs have trouble getting their tracheostomy tubes removed.

• 1
  The patient experienced severe inspiratory difficulty and supraglottic swelling, completely covering the opening of the glottis, when tracheostomy decannulation was attempted.
• 2
  Removal of the nasogastric tube (NGT) led to the gradual relief of upper airway edema, and the artificial airway was successfully removed two weeks later.
• 3
  Severe periglottic swelling may also be a symptom of NGTS, even in the absence of vocal cord paralysis and post-cricoid ulcer.