Endoscopic removal of a knotted nasogastric tube lodged in the posterior nasopharynx

The complication of knotting nasogastric (NG) tubes on removal occurs infrequently with small diameter feeding tubes. Knotting of large caliber NG tubes is even more uncommon. We describe our experience in one such case, which was further complicated by the inability to visualize the NG tube in the posterior pharynx for removal through the mouth. We also review the literature and discuss risk factors.