Nasogastric tube impaction with metal-like stiffening requiring endoscopic retrieval: Rare long-term complication with suspected drug association

Nasogastric (Ryle's) tubes are widely used for enteral feeding but may rarely cause complications like stiffening, degradation, and impaction. We report a case of tube impaction in a 67-year-old female with multiple comorbidities on prolonged levetiracetam therapy. Endoscopic removal revealed the tube to be unusually rigid and structurally altered. Two similar cases with long-term levetiracetam use suggest a possible association with tube degradation. Thus, we show the importance of timely tube replacement and the need for research on drug-material interactions.