Nasogastric tube insertion is a common bedside procedure. In an awake patient, unexpected passage into airway is easily noticeable due to the gag reflex; however, in the case of ventilated patients false cannulation is liable to be missed, unless insertion is carried out under direct visualization. We present a case of passage of nasogastric tube into peripheral bronchiole of the right lung, which was initially missed on chest radiography. This case report highlights the fallacy of relying on a chest radiograph.
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