Images Index > Image of the Day 8

Chest X-ray with NGT placed

A small-bore NGT is placed. Is placement confirmed?

Yes, placement is confirmed.

Annotated chest X-ray with NGT placed

Sorry! This one is tricky, and highlights the importance of evaluating more than just placement below the diaphragm. Here, we can see the tip of the NGT does indeed look like it courses below the diaphragm. However, let's go back up more proximally. Does the NGT convincingly cut through the airway segment without following the lumen? No! We can actually see the NGT following the path of the right mainstem bronchus rather than bisecting it. This NGT is in the lung! The other thing that would be needed for confirmation is traversal through the G-E junction; also not present here.

No, placement is NOT confirmed.

Annotated chest X-ray with NGT placed

Correct! While the NGT crosses below the diaphragm, it does not cross through the GE-junction, and does visibly follow the path of the right mainstem bronchus all the way down to a segmental level. This image highlights the importance of evaluating more than just placement below the diaphragm.