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Preschooler with superior mesenteric artery syndrome who had a feeding tube placed into the third part of the duodenum 1 day ago that is now not working. AXR (not available) showed the tip had migrated into the right upper quadrant of the abdomen

US of feeding tube tip in main portal vein
Transverse US of the liver shows the echogenic tip of a feeding tube to be in the main portal vein in the center of the image. Note the posterior shadowing from the tip extending inferiorly from it.

The diagnosis was feeding tube malfunction due to migration of the feeding tube tip out of the duodenum into the main portal vein. In the operating room the feeding tube was seen to have eroded into the superior mesenteric vein and then into the main portal vein and it was removed without complication.

Infant after feeding tube placement

AXR of feeding tube in mainstem bronchus, lung and pleural space with tension pneumothorax
AXR obtained immediately after feeding tube placement (left) shows a feeding tube going down the left mainstem bronchus and then turning up into the lung and increased lucency in the left costophrenic angle presumably due to the feeding tube entering the left pleural space. AXR obtained a minute later after feeding tube repositioning (right) shows the tip of the feeding tube in the antrum of the stomach and a large left pleural air collection with mediastinal shift to the right.

The diagnosis was feeding tube malfunction due to placement of the feeding tube through the airway into the lung and pleural space causing a tension pneumothorax.

Newborn after repair of a left-sided congenital diaphragmatic hernia

CXR after congenital diaphragmatic hernia repair showing no need for a chest tube
CXR AP (above) taken immediately postop shows that the hypoplastic left lung cannot expand to completely fill the pleural space particularly in the basilar region and subsequently there is a moderate amount of air in the pleural space. This should not be called a pneumothorax. CXR AP taken 1 day later (below) shows the left pleural space now filling with fluid.

The diagnosis was normal post-operative appearance after congenital diaphragmatic hernia repair.

Young adult with cystic fibrosis with continued shortness of breath after chest tube placement

CXR of chest tube malposition with chest tube in the lung parenchyma
CXR AP (left) shows chronic interstitial fibrosis and scarring in the lungs, a left-sided chest tube, and a moderately-sized basilar left pleural air collection manifesting as a deep sulcus sign. Gross pathological specimen (right) shows the left chest tube entering the upper lobe of the left lung.

The diagnosis was persistent pneumothorax in a patient with cystic fibrosis due to the chest tube tip not being in the pleural space.

Teenager in motor vehicle accident with continued shortness of breath after chest tube placement

CT of chest tube malposition with chest tube in the lung parenchyma
Axial and coronal and sagittal CT with contrast of the chest shows a large amount of air in the left pleural space. The left chest tube is clearly located within the air space disease in the posterior left lung parenchyma in all three planes.

The diagnosis was persistent pneumothorax in a thoracic trauma patient with pulmonary contusion due to the chest tube tip not being in the pleural space.

Premature newborn after chest tube placement

CXR of chest tube malfunction with chest tube in the subcutaneous tissues of the chest wall
CXR AP shows diffuse ground glass opacity throughout the lungs and a large amount of air in the right pleural space causing mediastinal shift to the left while the right-sided chest tube courses through the subcutaneous tissues of the right chest wall and never enters the right pleural space.

The diagnosis was persistent pneumothorax in a patient with respiratory distress syndrome due to the chest tube tip not being in the pleural space.

Infant who was on arterial-venous ECMO post cardiac arrest and has just been taken off of ECMO

CT of intraventricular hemorrhage, intracerebral hemorrhage, and cerebral atrophy in a patient on extracorporeal membrane oxygenation (ECMO)
Axial CT without contrast of the brain shows mixed-density fluid in the left lateral ventricle posteriorly and mixed-density fluid in the left parietal-occipital lobe. There is also diffuse prominence of the sulci and ventricular system.

The diagnosis was intraventricular hemorrhage on ECMO and intracerebral hemorrhage on ECMO and cerebral atrophy post ECMO.