Tube placement check film

Case contributed by Dr Derek Smith

Presentation

Intensive care admission due to sepsis. Request to check nasogastric tube placement as no aspirate obtained.

Patient Data

Age: 50 years
Gender: Male
X-ray

Nasogastric tube in appropriate position descending in the midline and passing below the diaphragm.

Endotracheal tube is sited above the carina, and the tip of the right internal jugular venous catheter is projected over the SVC.

No pneumothorax. Loss of left hemidiaphragm may represent infection or atelectasis.

Case Discussion

When patients are admitted to critical care, radiology plays an important role to ensure that medical interventions are not leading to harm.

Nasogastric tubes are notorious for ending up in the bronchi which if then used, can lead to disasterous outcomes for the patient.

Other common things to check for are central line catheters (with a risk of pneumothorax) and endotracheal tube placement.

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