Today our topic of discussion is Indications of Nasogastric Insertion.

Indications of Nasogastric Insertion

Indications

Therapeutic

To decompress the gastrointestinal tract, e.g. in paralytic ileus, intestinal obstruction and acute dilatation of stomach
To keep the stomach empty to give local rest, e.g. in peritonitis, after intestinal anastomosis
To prevent distension of abdomen, especially after repair of the incisional hernia
After an esophagus operation, e.g. resection of growth excision of diverticulum, suturing of esophageal tear correction of tracheoesophageal fistula

Feeding: Nasogastric tube feeding in unconscious and comatose patients to maintain nutrition and nasogastric hyperalimentation, especially in malnourished patients and low fecal fistula
Gastric lavage: Alchohol or non-corrosive poisoning of in hematemesis
Prerequisite: Before facial surgery. Also used in major faciomaxillary injury.

Diagnostic

Aspiration of gastric juice to know secretory activity and mobility of the stomach in chronic gastric ulcer, chronic duodenal ulcer, pyloric obstruction, gastric carcinoma and Zollinger-Ellison syndrome
In abdominal trauma: If Ryle’s tube aspirate is blood stained, it indicates injury to the stomach and an emergency laparotomy is indicated
To differentiate the bleeding above the pylorus from bleeding from below the pylorus. If blood is present in gastric samples but present in duodenal samples, then bleeding is from distal to pylorus

Collection of duodenal contents to diagnose typhoid carriers and to demonstrate tuberculosis bacilli in children and recumbent patients who cannot expectorate
To diagnose pseudopancreatic cyst: Lateral view of the abdomen after Ryle’s tube is in the stomach, shows the tip near the abdominal wall due to compression of the stomach by cyst from behind (Fig. 28.39).

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