If the tip of the tube cannot be seen because it passes further below the
diaphragm than can be seen on the X-ray, there are three options
1. It may be that the X-ray does not cover enough of the area below the diaphragm
to see the tube and a further image is required
2. Sometimes the body of the stomach extends quite inferiorly in the abdominal
cavity, but the duodenum is relatively fixed. Therefore, if the tube is in the duodenum it
can usually be seen to loop back superiorly and to the right before turning inferiorly and
tracking back towards the midline again
3. A tube that does not do this may well still be in the stomach. In this situation it is
useful to use measurements
The length of NG tube to be inserted as a minimum is the same as the distance
from the nasal septum to the tragus of the ear and then to the xiphisternum
If the tip of the tube cannot be seen but the length of tube in situ is this distance
plus up to 15cm then it is acceptable to feed
