Transnasal ileus tube-associated ileal perforation with penetration into the adherent sigmoid colon: a rare case report

A transnasal ileus tube is an important treatment for intestinal obstruction. However, complications such as nasopharyngeal pain, abdominal discomfort, bleeding, and intussusception may occur during its use, and an ileosigmoid fistula is a rare complication. We report the case of a 56-year-old woman with recurrent adhesive small bowel obstruction (SBO) who developed an ileosigmoid fistula after transnasal ileus tube placement. The insertion procedure was uneventful, and the patient did not experience pain or discomfort during or after the procedure. Plain abdominal radiography and computed tomography (CT) showed that the tip of the tube was located within the sigmoid colon, and the ileosigmoid communication was confirmed by colonoscopy. The patient subsequently underwent surgery and recovered uneventfully. An ileosigmoid fistula can develop after transnasal ileus tube placement even in the absence of clinical signs or symptoms during insertion.