Nasogastric tube position on chest x-ray (summary)
Citation, DOI, disclosures and article data
Citation:
Jones J, Knipe H, Ayesa S, et al. Nasogastric tube position on chest x-ray (summary). Reference article, Radiopaedia.org (Accessed on 21 Mar 2025) https://doi.org/10.53347/rID-31405
rID:
31405
Article created:
Disclosures:
At the time the article was created Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Radiopaedia Events Pty Ltd, Speaker fees (past)
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Henry Knipe's current disclosures
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- NG tube position on chest x-ray (summary)
This is a basic article for medical students and other non-radiologists
Nasogastric (NG) tube position on chest x-ray should be assessed following initial placement and on subsequent radiographs.
Reference article
This is a summary article; we have a more in-depth reference article NGT.
Summary
-
confirming position
- x-rays are only performed when the position is uncertain
- most tube positions are checked by assessing pH of tube aspirate
-
normal
- tube descends the thorax in the midline
- tube bisects the carina
- tube crosses the diaphragm in the midline
- the tip sits below the diaphragm
-
viewing the tube
- you need to be confident that you can see the tip
- most tubes are visible on a chest x-ray without a guide wire
- changing the windowing of the radiograph is helpful
- if you are not sure, discuss with a senior
-
malposition
- nasogastric tubes may end up in the airways
- feeding through a malpositioned tube can be disastrous
Quiz questions
Question 2099
A premature male neonate (born at 33 weeks gestation) underwent CXR which confirmed the presence of respiratory distress syndrome (RDS) and a left-sided pneumothorax. Subsequently, as a part of the treatment, multiple tubes/lines were placed. Which of the following tube/line is malpositioned on the shown chest x-ray?
References
- 1. NHS National Patient Safety Alert (2011) PDF
Incoming Links
Cases:
- Malpositioned nasogastric tube in right main bronchus
- Misplaced nasogastric tube
- Nasogastric tube in the right lung
- Surfactant deficiency disorder and Broviac line
- Overlying densities simulating pneumothorax
- Malpositioned nasogastric tube
- Kinked nasogastric tube
- Spinnaker sign - pneumomediastinum
- Nasogastric tube terminating in left bronchus
- Misplaced nasogastric tube - right main bronchus
- Nasogastric tube position confirmation
- Misplaced nasogastric tube
- Normal positioning of chest lines and tubes (portable radiograph)
- Feeding tube in the pleural space
- Misplaced nasogastric tube - pharyngeal perforation
- Nasogastric tube in left lower lobar bronchus
- Incorrect nasogastric tube positioning
- Nasogastric tube in right main bronchus
- Misplaced nasogastric tube into the left lung
- Misplaced nasogastric tube resulting in pneumothorax
Multiple choice questions:
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