CTICasesIatrogenic NG Tube Malposition with Mediastinal and Pleural Perforation
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Imaging findings
Post-cardiac surgery chest x-ray showed an NG tube taking an unusual course, not entering the stomach. CT with contrast confirmed malposition, showing contrast in the pleural space and the NG tube itself within the pleural space. The tube was observed to have entered the piriform sinus, tracked through the mediastinum, and perforated into the pleural space, rather than the more common route through a bronchus.
Key takeaways
NG tube malposition is an iatrogenic complication that can lead to serious consequences such as mediastinal and pleural perforation. Careful review of NG tube course on post-placement imaging is essential, as the route of perforation can vary (e.g., pharyngeal/mediastinal vs. bronchial).
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