Feeding tube in hiatal hernia mimics intrapulmonary tube placement

Case contributed by Stefan Tigges
Diagnosis certain


Line placement.

Patient Data

Age: 80 years
Gender: Male

Coiled distal feeding tube projects over the medial right lung base. In the neck, the proximal feeding tube is adjacent to but not in the airway. Enlarged cardiac silhouette, multifocal consolidation.

CT chest from one day prior


Large hiatal hernia, multifocal consolidation, small bilateral pleural effusions.

Case Discussion

On the radiograph, the feeding tube tip projects over the medial right lung base, mimicking pulmonary tube placement. But in the neck, the tube is clearly adjacent to and not in the airway. A CT from the previous day shows a large hiatal hernia with a componenet located just lateral to the right heart border, corresponding to the location of the feeding tube on the next day's radiograph.

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