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![Figure 2.](/view/journals/anpr/68/2/inline-i0003-3006-68-2-90-f02.png)
Nasogastric tube (NGT) tightly knotted to the withdrawn nasal tracheal tube (NETT).
![Figure 1.](/view/journals/anpr/68/2/inline-i0003-3006-68-2-90-f01.png)
Radiographic image of head and neck. Loop of nasogastric tube shown in hypopharynx (white arrow) and knot shown in nasopharynx (black arrow).
![Figure 3.](/view/journals/anpr/68/2/inline-i0003-3006-68-2-90-f03.png)
Model used to theorize how the nasogastric tube (NGT) might have become knotted around the nasal tracheal tube (NETT). (A) The NGT folded and turned backward toward the oropharynx, leading to its appearance in the oral cavity after the first (blinded) intubation attempt. (B, C) The NGT and NETT became entwined and formed a loose knot, although this maneuver was performed under direct vision with forceps. (D) The motion of pulling the NGT (arrow) to move the knot upward toward the nasopharynx led to tight knotting of the NGT to the NETT.