Iatrogenic intubation injuries of the upper gastrointestinal tract in adults

Perforation of the hypopharynx, esophagus, and stomach complicated the insertion of flexible tubes in 11 adults. Nasogastric suction tubes were responsible for 5 instances of gastric perforation. Palliative intubation of obstructive carcinomas of the distal esophagus resulted in delayed perforation of the esophagus and stomach in 2 cases. The use of a Linton tube for decompression of bleeding varices caused esophageal rupture in 1 patient whereas 2 others developed pharyngoesophageal perforation due to misplaced endotracheal tubes. The remaining 1 case demonstrated penetration of a chest tube into the esophageal lumen. The radiographic features and mechanisms of these iatrogenic injuries are described and the pertinent literature is reviewed.