Postoperative Nasogastric Tube Syndrome Without Throat Pain Following Emergency Abdominal Surgery: A Case Report

Vocal cord paralysis is a recognized complication of tracheal and nasogastric tube insertion. When associated with nasogastric tube insertion, it is termed nasogastric tube syndrome (NGTS). This syndrome is classically characterized by a triad of throat pain, presence of a nasogastric tube, and vocal cord paralysis, which is often bilateral. A 75-year-old man developed stridor and dyspnea without throat pain 12 days after tracheal extubation, while a nasogastric tube had remained in place for 18 days. The following day, laryngoscopy performed by an otolaryngologist revealed median vocal cord fixation with bilateral vocal cord paralysis. The bilateral involvement, along with the patient's symptoms and clinical course, supported the diagnosis. A tracheostomy was subsequently performed. Follow-up laryngoscopy revealed residual vocal cord dysfunction, although partial recovery of mobility was observed. NGTS should be considered in the differential diagnosis of vocal cord paralysis in patients with a history of nasogastric tube insertion, even in the absence of throat pain. Early recognition in the postoperative period is essential to guide appropriate management.