Fluoroscopic nasojejunal tube insertion
Fluoroscopic nasojejunal (NJT) or nasogastric tube (NGT) insertion is a valuable procedure offered by radiologists in patient care.
The majority of nasogastric tubes are inserted on the ward level and nasojejunal tubes may be placed in theatre at the time of surgery. In difficult cases, insertion under fluoroscopic guidance is undertaken.
- nasogastric or nasojejunal tube (with radio-opaque and ideally weighted tip)
- bowl of warm water (to immerse the tube in)
- lidocaine infused lubricant gel or local anaesthetic spray
- adhesive sticker (to secure to nose/face after completion)
Typically the initial insertion over the pharynx into the oesophagus (avoiding insertion into the larynx and tracheobronchial tree) is performed in the lateral position, reverting to the AP position for progress into the distal oesophagus, stomach and small bowel.
In the case of a nasojejunal tube, the tip position at or beyond the duodenojejunal flexure (ligament of Treitz) is desirable. It may move further distally over time with peristalsis.