Unrecognized chest tube entrapment by surgical closure is a technical error. We present a rare case of chest tube entrapment that was successfully treated with a simple and safe solution in an elderly man after coronary artery bypass grafting (CABG). We visualized the suture using a small endoscope through the chest tube and incised it with the help of thoracoscopic scissors. The tube was then removed without the need for surgical exploration.
Re-expansion pulmonary edema (RPE) after chest drain insertion is rare. The objective of this clinical case report is to highlight the importance of this chest drain insertion complication. A 35-year-old man presented to the emergency department with a chief complaint of shortness of breath and pleuritic chest pain. Further physical examination and radiographic investigations showed a left-sided hemipneumothorax. A chest drain was inserted, but subsequently the patient developed worsening shortness of breath, desaturation, and coughed out pink frothy sputum. Repeated chest radiographic and computed tomographic thorax findings suggested RPE. A nonrebreathable mask with high-flow oxygen was given to the patient to maintain his oxygen saturation. The patient was referred to the cardiothoracic team and was admitted to the hospital. Despite conservative management in the ward, the patient underwent lung decortication. Postdecortication, the left-sided lung re-expanded well, and the patient was discharged home. This case highlighted this rare, potentially fatal complication of chest drain insertion for spontaneous pneumothorax.
An injury to the left ventricle after a chest tube insertion is a rare but lethal phenomenon that is likely to occur if precautions are not seriously addressed. We present a 15-year-old girl who was diagnosed a left empyema thoracis. An attempt to place a chest drain in this young girl was almost fatal. A left ventricular repair together with thoracotomy and decortication were successful. This case emphasizes the rarity of this lethal complication and the importance of the correct technique for chest tube insertion.