Endobronchial nasogastric tube
Dysphagic following stroke. No aspirate gained from NG tube.
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Nasogastric tube inserted far into the right lower lobe bronchus, advanced to the costophrenic recess.
No pneumothorax or lung complication.
This is a prime example of the importance of a structured review for NG tube placement.
This tube appears to "bisect" the carina and the tip projects well below the diaphragm, but it does not cross the diaphragm in the midline and instead has followed the right lower lobe bronchus down about as far as it can go!
Tube removed and successfully replaced under fluoroscopic guidance.