[Naso-intestinal intubation with weighted tubes. A new modification of an old technique]

We have studied the spontaneous transpyloric passage of 25 weighted nasointestinal tubes using a modified technique slightly different from the standard one. Instead of introducing the entire tube in the stomach in the very first moment, we have only introduced at the beginning approximately 70 cm and afterwards, with the patient in the right lateral decubitus position, each 15 minutes we continued introducing 15 cm each time for a total period of one hour. X-ray controls were done 3, 24 and 48 hours after the first introduction. Fifteen tubes (60%) had passed to the small intestine in the first 3 hours, 21 (84%) had reached it before 24 hours and 23 (92%) had passed the pylorus before 48 hours. The others two tubes did not pass the pylorus in 48 hours nor did they pass after the administration of metoclopramide. We thus conclude that this technique simplifies the intubation of the small intestine. We recommend to control the position of the tube by X-ray film 24 hours after the positioning. If after this period the tube is still in the stomach, it should be repositioned using radiological or endoscopic assistance in those cases that the delivery of an intestinal solution is desired.