Perforation of the nasopharynx by nasogastric intubation: a rare cause of left pleural effusion and pneumomediastinum

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Abstract
A case of nasogastric tube perforation of the posterior nasopharynx producing a left pleural effusion and pneumomediastinum is reported. Findings which led to the correct diagnosis were the rapid appearance of a left pleural effusion simultaneous with the initiation of tube feedings, the intrathoracic location of the nasogastric tube, and demonstration of perforation of the posterior nasopharynx. Potentially hazardous intubation techniques are discussed.