Nasogastric tube position on chest x-ray (summary)

Last revised by Henry Knipe on 26 Apr 2022
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.


  • 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

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Cases and figures

  • Case 1: correct placement of nasogastric tube
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  • Case 1: annotated image of correct placement
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  • Case 2: NG tube looped around carina
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  • Case 3: correct placement
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