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Esophageal Obstruction Associated with Enteral Feedings with Nepro®: an Unreported Event

Nonihal Singh, Suman B Thapamagar and Shanker Mukherjee

We report a unique case of esophageal obstruction related to orogastric (OG) tube feedings with Nepro. The patient was an 84 year old male who was on mechanical ventilation for severe respiratory distress. He was started on Nepro® via an OG tube. Seven days later, while reinserting the OG tube, an esophageal obstruction was identified. On the same day, esophago-gastroduodenoscopy was done for esophageal disimpaction. Subsequently, we concluded that the Nepro® feed, which precipitated and solidified, caused obstruction of the entire esophagus. We report that Nepro® feeds have the property of solidifying and causing obstruction especially in recumbent patients who do not have the benefit of gravity for food propulsion. Such obstructions have been reported for other enteral nutrition formulations, but to the best of our knowledge, this is the first reported case for Nepro® and hence it should be added to the list of complications.