Nasogastric tube - insufficient length

Case contributed by Dr Derek Smith

Presentation

Head and neck cancer patient. Nasogastric tube (NGT) inserted for feeding. No aspirate gained following placement.

Patient Data

Age: 65
Gender: Male

The NGT is following the right course but is sitting in the oesophagus.

If advanced about 10 cm it is likely to be in the stomach.

Bibasal atelectasis.

X-ray

Despite advancing the tube, no aspirate obtained

This NGT is sufficiently advanced and passes along the midline with the tip well below the diaphragm. This will be safe for feeding.

Case Discussion

Recognising correct nasogastric tube positioning is an important clincial skill. In this case the NGT was on the right path but would not have been suitable in it's initial position sitting in the oesophagus. The patient was reimaged as although the tube was then in the correct position, no aspirate could be obtained and so a further check x-ray was performed.

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Case contributed by Dr H Hare.

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Case information

rID: 37133
Case created: 27th May 2015
Last edited: 13th Aug 2015
Inclusion in quiz mode: Included

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