IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Misplaced nasogastric tube

Case contributed by Andrew Murphy
Diagnosis certain

Presentation

Chest x-ray to assess progression of pneumonia and confirm nasogastric tube position.

Patient Data

Age: 85 years
Gender: Male

Day 1

x-ray

Nasogastric tube is positioned within the left lower lobe bronchus and repositioning is required.

Ill-defined air space opacity in the right mid and lower zone associated peribronchovascular thickening likely due to infection or aspiration. Probable small right pleural effusion.

Day 2

x-ray

Tip of the weighted nasogastric tube is located within the gastric body.

Ill-defined nodular opacities and subtle interstitial thickening in the right mid/lower zone and medial left lower zone has slowly improved since earlier radiograph from day 1 and likely due to aspiration or infection. 

Case Discussion

The ideal position of a nasogastric tube should be in the sub-diaphragmatic position in the stomach. Ideally it should be at least 10 cm beyond the gastro-esophageal junction 1.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.