Nasogastric tube positioning

Assessment of nasogastric (NG) tube positioning is a key competency of all doctors as unidentified malpositioning may have dire consequences, including death.

The ideal position should be in the sub-diaphragmatic position in the stomach - identified on a plain chest radiograph as overlying the gastric bubble. Ideally, it should be at least 10 cm beyond the gastro-oesophageal junction 1.

Malpositioning may include tip position:

  • remaining in the oesophagus
  • traversing either bronchus or more distally into the lung
  • coiled in the upper airway

In some circumstances fluoroscopic nasojejunal tube insertion is necessary.

Chest x-ray
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Article information

rID: 30966
Section: Approach
Tag: refs
Synonyms or Alternate Spellings:
  • NG tube position
  • NGT position
  • Evaluation of nasogastric tube position

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Cases and figures

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    Case 1: appropriate NGT position
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    Feeding tube inse...
    Case 2: NG coiled in upper airway
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    Case 3: NG in distal oesophagus
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    Case 4: NG in right lung
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    Case 5: NGT coiled in nose
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    Case 6: appropriate position
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    Case 7: down both bronchi
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    Case 8: misplaced nasogastric tube
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    Case 9: right lower lobe
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    Case 10: left lower lobe with pneumothorax
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    Case 11: curved back in the mid oesophagus
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    Case 12: iatrogenic bronchopleural fistula from a Dobhoff tube
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    Case 13: malposition of nasogastric tube causing right PTX
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    Case 14: in the left lower lobe bronchus
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