Incorrect nasogastric tube positioning

Case contributed by Derek Smith
Diagnosis certain

Presentation

Nasogastric tube position check - stroke patient, unsafe swallow.

Patient Data

Age: 50
Gender: Female

Poor rotation to film.

Nasogastric tube seen crossing midline and following course of right main bronchus.

This is not appropriate and should be removed as soon as possible.

Also, bowel distention noted with raised left hemidiaphragm.

Case Discussion

This NG tube is not in a safe place and should be removed at the earliest opportunity.

The patient is at risk if feeding is started (pneumonitis, aspiration) and incorrectly placed NG tubes are potentially fatal.

(Thanks to Dr Gilly Fleming for the case)

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