Background: Nasogastric tube insertion is a routine, simple and seemingly innocuous procedure. It can cause
unexpected and serious complications. We report a rare case of haemopneumothorax following nasogastric tube insertion and discuss strategies to prevent the complications.
Case Report: A 37 year old with learning difficulty was admitted with a fall. Initial diagnosis was that of Acute Coronary Syndrome for which appropriate treatment was started. He complained of difficulty
in swallowing and a nasogastric tube was passed in order to maintain his nutrition. Chest x-ray
post procedure revealed the tip of the feeding tube in right hemithorax with an air-fluid level.
Intercostal drain was inserted and drained 400 ml of hemorrhagic fluid with resorption of air
leading to full lung expansion.
Conclusions: Nasogastric tube insertion can cause serious complications. It can lead to tracheopulmonary, nasopharyngeal, esophageal and gastric trauma and perforation. These complications are potentially life-threatening and can lead to death. Be cautious while inserting nasogastric tube.
Never push the tube against resistance and while the patient is coughing.

Keywords: Haemopneumothorax, Pneumothorax, nasogastric tube