Teenager with bilious returns from the nasogastric tube

AXR of post-pyloric nasogastric tube
Supine AXR shows the tip of the feeding tube to be in the gastric body and the tip of the nasogastric tube to be in the third part of the duodenum – the exact opposite of what their normal positions should be.

The diagnosis was placement of the nasogastric tube tip post-pyloric in the duodenum.