Anatomically, the right main bronchus is straighter than the left. Nasogastric tubes are hence more likely to be incorrectly advanced into the right main bronchus. In this case, the rare occurrence of the tube is inserted into the left main bronchus occurs before it coils and makes its way into the right main bronchus.
Care should always be taken when advancing a nasogastric tube. Feeding should not be carried out if imaging has not demonstrated the tube in the stomach 1. Complications from incorrect nasogastric tube positioning in the lower airway include aspiration pneumonia, pneumothorax, hemorrhage and empyema.