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Endotracheal tube in right main bronchus with left lung collapse in evolution

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Mobile CXR post NGT placement

Patient Data

Age: 55
Gender: Female

The endotracheal tube has its tip in the right main bronchus. There is shift of the mediastinum to the left, elevation of the left hemidiaphragm and generally increased density in the left hemithorax. All these are features of volume loss and an indication that collapse of the left lung is imminent unless the ETT is withdrawn by at least several centimeters. The nasogastric tube is appropriately positioned. 

Case Discussion

An example of a malpositioned endotracheal tube with tip in the right main bronchus and features of developing left lung collapse (reduced volume, mediastinal shift, increased density). 

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