Abstract

Gastric aspiration alone utilizing either a Levin-type nasogastric tube or a gastrostomy tube is inefficient. The esophagus proved to be a more efficient supplemental site for aspiration of a swallowed bolus. For thirty-one patients, esophagogastric aspiration proved to be approximately twelve times as efficient as aspiration via a Levin-type tube for twenty-four patients or a gastrostomy tube in five patients (residual activity, of 3,35, and 42 per cent, respectively). Radiographic studies of a volunteer swallowing barium with each type of nasogastric tube in place showed efficient removal of the contrast agent by esophageal aspiration. With the Levin-type tube, the bolus promptly traversed the stomach and entered the duodenum along parallel channels remote from the x-ray -visualized gastric tube. Efficient postoperative exclusion of swallowed air clinically and experimentally by esophageal aspiration permits more rapid return of gastrointestinal function and full nutrition and perhaps shortened hospitalization.