Taiwan Crit. Care Med.2012;13:198-202 Wei-Fan Hsu et al.
Esophageal milk curd in an adult: a rare cause of
Wei-Fan Hsu1, Chen-Shuan Chung1, Yeong-Long Hsu1, Hou-Tai Chang1,2
Nasogastric tubes are commonly used in several medical scenarios. Confirmation
of the position of the nasogastric tube is essential. Herein, we report the case of
an 81-year-old male who suffered from persistent pneumonia despite administration
of antibiotics for four weeks. Esophagogastroduodenoscopy revealed that the entire
esophagus was obstructed by milk curd, which was subsequently removed by warm
water instillation. Tracing back his chest X-ray, it showed the nasogastric tube was malpositioned
in the lower thoracic esophagus. The patient became ventilator dependent, and he was discharged after a full course of antibiotics and correct
replacement of the
nasogastric tube. This report is the first to find milk curd in the esophagus in an adult,
and highlights the infrequent but serious complication of misplaced nasogastric tubes.
Special attention should be paid to the proper positioning of an indwelling catheter on
Key Words: Esophagogastroduodenoscopy, Esophagus; Milk curd, Nasogastric tube,