NGINX and other servers offer the option to use named pipes (mkfifo).
Can erlang use these instead of ports for nif interaction. What if I wanted to make 70,000 connections to my NIF (don't judge).
In short, no.
This is covered in the Erlang FAQ on opening device files. It boils down to it being hard/impossible to write the Erlang runtime in a portable way across Unices (not to mention Windows) so that it can access things like device files and named pipes without blocking on at least some of them. That blocking would screw up the "soft realtime" nature of the Erlang runtime.
What is possible is to write a C program that communicates with the Erlang runtime as a "port process", and that program can communicate over the named pipe (and block or not or whatever without screwing up the Erlang runtime).