Large-bore tubes (28 to 40 Fr) are used for gastric decontamination and charcoal instillation. The use of these tubes has come into relative disfavor in recent years. 4 This was not because of complications but rather because of a lack of proven efficacy. Complications have only been rarely reported with the use of the tubes but have included esophageal tears and inability to remove the tube secondary to esophageal spasm. If an orogastric lavage tube cannot easily be removed, the patient should undergo fluoroscopic examination with contrast in order to determine its exact location and any kinking. If the tube is simply stuck because of esophageal spasm, glucagon can be given to assist in its removal.5
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