Nasogastric tube in left lower lobar bronchus

Case contributed by Muhammad Shoyab

Presentation

Severe headache and vomiting followed by loss of consciousness. Extensive intracranial hemorrhage on CT.

Patient Data

Age: 30 years
Gender: Male

Chest A/P (Supine) View

x_ray

Nasogastric tube is identified along the course of trachea and left principal bronchus. Its tip is seen in lower zone of left lung field, instead of left hypochondriac area.

Endotracheal tube is in trachea, with its tip several centimeters above carina, which is higher than normal.

Inhomogeneous haziness is noted over upper zones of both lung fields. Multiple ill-defined patches of airspace opacification interspersed with multiple tiny round lucencies having opacified walls are also noted over middle & lower zones of right lung field.

Case Discussion

This was a check x-ray done to confirm the position of the tubes. Position of nasogastric tube was immediately corrected after this. The patient ultimately succumbed to intracranial hypertension and other complications produced by the intracranial hemorrhage.

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