E1157. Tube Misplacement Across the Ages
  1. Ariel Lewis; Jacobi Medical Center
  2. Einat Blumfield; Montefiore Medical Center
  3. Bernard Goldwasser; Jacobi Medical Center
  4. Jeremy Neuman; Main Street Radiology
  5. Jason Dipoce; Reading Hospital
  6. Mark Guelfguat; Jacobi Medical Center
Enteric tube misplacements are surprisingly common. Most of them are identified early and can be rectified by simple repositioning. Tube misplacements can result in iatrogenic injuries leading to devastating morbidity. In this presentation we illustrate in detail a diverse range of complications from the most trivial to the most severe. This exhibit introduces an organized approach to the spectrum of tube misplacements and highlights the salient risk factors that lead to them. Additionally, common complications of the misplacements are discussed. Mimickers are shown and contrasted. Both imagers and clinicians should recognize these findings in order to prevent severe patient outcomes.

Educational Goals / Teaching Points
By the end of this exhibit participants should be able to identify a wide spectrum of alimentary tract feeding tube misplacements ranging from pharyngeal looping to gastric perforation, feel comfortable with identifying tracheo-pulmonary misplacement and its range of pathology from the more common bronchial positioning to the rare transpulmonary perforation with retroperitoneal lodging of the tip, know and understand the injuries resulting from feeding tube malpositioning, and be able to differentiate tube misplacement mimickers from real tube misplacements.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit uses a combination of radiographs, ultrasound images, fluoroscopic images, and CT scans of the neck, chest, and abdomen to illustrate a wide range of feeding tube malpositions. Imaging of common mimickers are also presented to differentiate true feeding tube malpositions from benign lookalikes.

While most enteric tube misplacements are identified early and are harmless, many can result in injury leading to significant morbidity and mortality in both the adult and pediatric populations. Being able to quickly identify and rectify these malpositions is important for both radiologists and clinicians.