Medical image of the week: Dobhoff placement in a patient with hiatal hernia

No abstract available. Article truncated at 150 words. A 79 year-old woman with a past medical history of obstructive sleep apnea, chronic obstructive pulmonary disease on home oxygen, obesity hypoventilation syndrome, hypertension, and anxiety presented with a 2 day history of altered mental status...
Ausführliche Beschreibung

No abstract available. Article truncated at 150 words. A 79 year-old woman with a past medical history of obstructive sleep apnea, chronic obstructive pulmonary disease on home oxygen, obesity hypoventilation syndrome, hypertension, and anxiety presented with a 2 day history of altered mental status and symptoms consistent with a COPD exacerbation, including dyspnea and increased oxygen requirements. She was found to be hypercarbic and did not tolerate a trial of BiPAP due to her altered mentation. She was subsequently intubated. Due to an expected prolonged intubation period, plans for enteral access were made. A Dobhoff naso-duodenal feeding tube (DHT) was inserted. On chest radiograph and a concurrent abdominal radiograph, the DHT appeared to have been inserted into the left mainstem bronchus terminating in the left lower lobe (Figure 1A and 1B). The nursing staff removed and replaced the DHT resulting in a similar radiograph. A third placement was attempted with similar radiographic results. Therefore, a computed tomography (CT) … Ausführliche Beschreibung