Which other patient group is contraindicated for blind placement of a feeding tube?

• A. Status post gastric bypass surgery
• B. Allergy to latex
• C. Asthma
• D. Current smoker

Answer: (A)

Blind placement assumes normal gastrointestinal anatomy to guide the tube into the stomach without imaging. After gastric bypass surgery, anatomy is altered: a small proximal pouch is connected to a distal Roux limb, bypassing much of the stomach. This makes blindly advancing a feeding tube risky because the tube can misplace into the bypassed stomach remnant or into the small bowel, potentially causing malposition, perforation, or feeding into an area not suited for nutrition. For this reason, blind placement is contraindicated in patients with a history of gastric bypass; placement should be done with endoscopic or radiographic guidance and confirmation of position.

Latex allergy would mainly affect the materials used, not the safety of the blind technique itself; asthma and smoking don’t inherently change the risk of blind placement.