Premature newborn after placement of a nasogastric tube

Upper GI of esophageal perforation caused by nasogastric tube
AXR AP (above left) shows the nasogastric tube to follow a rather straight course into the abdomen. There is increased lucency in the upper abdomen. Subsequent AXR decubitus (above right) shows free air between the abdominal wall and liver. AP view obtained 9 days later immediately after the injection of water soluble contrast through the nasogastric tube (below left) shows some contrast extravasating out of the esophagus into the mediastinum and some contrast entering the stomach. Lateral view obtained 15 minutes later (below right) shows contrast outlining the left pleural space.

The diagnosis was nasogastric tube malposition with the nasogastric tube causing esophageal perforation.