RYLES TUBE- COMMONLY FORGOTTEN ENTITY AFTER INSERTION

Background: Ryles tube insertion is required for feeding purpose in many patients suffering from different kinds of diseases, especially neurological disorders and head injury where they are required for prolonged periods, thus merit regular and timely exchange of the same.

Case Report: A fifty-five-year-old male patient, not a known case of any chronic illness, chronic smoker and alcoholic for last twenty years, presented with gradually progressive dysphagia for last three months and on endoscopic evaluation was found to having post-cricoid with extension in upper esophagus. His computed tomography scan of chest and abdomen showed metastasis, hence surgical option was ruled out. In view of growth being squamous cell carcinoma, he was planned for radiotherapy and Ryles tube was inserted under endoscopic guidance. The treating radiotherapist and family members were clearly explained for change of Ryles tube, not later than two months or it becomes hard, whichever is earlier. His radiotherapy session was given over six months period but both the treating team and family members forgot to get it exchanged. Once, feed stopped to be given from blockage of Ryles tube, then patient was brought for check endoscopy and change of Ryles tube. On endoscopy, Ryles tube was found to be kinked & stucked at gastroesophageal junction and it had become very hard. It was removed endoscopically tactfully with help of foreign body forceps. A new Ryles tube was inserted and patient was observed over next one day and he was accepting feeds normally through new Ryles tube. The patient, family members and treating team was again re-explained the need of timely change of Ryles tube for preventing any complication.

Conclusion: Ryles tube insertion is a very common procedure done in plenty of needy patients on daily basis. Every procedure has its own complications which can be both immediate or delayed. Hence, awareness for the same is mandatory in treating team of doctors, patient and their family members for preventing complications of the same.