Presentation
Unsafe swallow due to bulbar dysfunction - awaiting RIG placement.
Patient Data
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Tube descends in midline but tip only just at level of esophageal-gastric junction. Advance a few centimeters before commencing feeding.
Cardiomegaly, sternal wires and biventricular pacemaker noted.
Tube tip well below diaphragm - beyond limits of this film, is it at an appropriate length?
Right mid-zone opacification progressing from previous imaging.
Tip again retracted - advance prior to feeding.
Right midzone opacification unchanged from previous imaging.
Case Discussion
This case illustrated how mobile nasogastric tubes can be - especially with older patients. These are just a selection of this patient's multiple CXRs to confirm tube positioning over his admission prior to getting a permanent feeding solution.
Appropriate documentation of length of insertion on the ward is useful when re-positioning these tubes.