Nasogastric tube position on chest x-ray (summary)

Radiopaedia • CC-by-nc-sa 3.0 • de
This is a basic article for medical students and other non-radiologists

Nasogastric (NG) tube position on chest x-ray should be assessed following initial placement and on subsequent radiographs.

Reference article

This is a summary article; we have a more in-depth reference article NGT.

Summary

  • confirming position
    • x-rays are only performed when the position is uncertain
    • most tube positions are checked by assessing pH of tube aspirate
  • normal
    • tube descends the thorax in the midline
    • tube bisects the carina
    • tube crosses the diaphragm in the midline
    • the tip sits below the diaphragm
  • viewing the tube
    • you need to be confident that you can see the tip
    • most tubes are visible on a chest x-ray without a guide wire
    • changing the windowing of the radiograph is helpful
    • if you are not sure, discuss with a senior
  • malposition
    • nasogastric tubes may end up in the airways
    • feeding through a malpositioned tube can be disastrous