Misplaced nasogastric tube

Case contributed by Andrew Murphy

Presentation

Chest x-ray to assess progression of pneumonia and confirm nasogastric tube position.

Patient Data

Age: 85 years
Gender: Male

Day 1

X-ray

Nasogastric tube is positioned within the left lower lobe bronchus and repositioning is required.

Ill-defined air space opacity in the right mid and lower zone associated peribronchovascular thickening likely due to infection or aspiration. Probable small right pleural effusion.

Day 2

X-ray

Tip of the weighted nasogastric tube is located within the gastric body.

Ill-defined nodular opacities and subtle interstitial thickening in the right mid/lower zone and medial left lower zone has slowly improved since earlier radiograph from day 1 and likely due to aspiration or infection. 

Case Discussion

The ideal position of a nasogastric tube should be in the sub-diaphragmatic position in the stomach. Ideally it should be at least 10 cm beyond the gastro-esophageal junction 1.

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