Images in Cardiothoracic Medicine and Surgery
Chest tube injury penetrating the right middle lobe of the lung
Asian Cardiovascular & Thoracic Annals 2015, Vol. 23(5) 601 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313518542 aan.sagepub.com
Tsuyoshi Takahashi, Masamitsu Murata and Makoto Tanaka
Figure 1. Computed tomography revealing the chest tube penetrating the right middle lobe, with an infiltrative shadow around the injury site.
An 81-year-old woman was admitted to our hospital with dyspnea on exertion. She had undergone aortic valve replacement 2 days earlier because of aortic stenosis. A right pleural effusion was detected on chest radiography. After confirming the location of pleural effusion by ultrasonography, an 18F chest tube was inserted through the 5th intercostal space on the anterior axillary line. Lung injury was suspected when the patient developed hemoptysis and blood gushed into the tube. Computed tomography revealed that the chest tube had penetrated the right middle lobe, and an infiltrative shadow appeared around the injury site (Figure 1). Video-assisted thoracoscopic surgery was performed to repair the injury. There was a wide adhesion in the right middle lobe, and the chest tube was placed around the right middle lobe. After removing the chest tube, the orifice in the right middle lobe (Figure 2) was closed using 4/0 polydioxanone II sutures. The patient recovered with an uneventful postoperative course. In this case, owing to the adhesion in the lung, the parenchyma appeared as an echo-free space on ultrasonography. This case emphasizes the importance of carefully following the correct technique while performing the widely used procedure for inserting a chest tube.
Figure 2. After removing the chest tube, the orifice (arrows) can be seen in the right middle lobe.
Funding This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.
Conflict of interest statement None declared.
Department of Thoracic Surgery, JR General Hospital, Tokyo, Japan Corresponding author: Tsuyoshi Takahashi, MD, Department of Thoracic Surgery, JR General Hospital, 2-1-3 Yoyogi, Shibuya-ku, Tokyo, 151-8528 Japan. Email: [email protected]
Downloaded from aan.sagepub.com at UNIV OF FLORIDA Smathers Libraries on November 15, 2015
Chest tube injury penetrating the right middle lobe of the lung
Asian Cardiovascular & Thoracic Annals 2015, Vol. 23(5) 601 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313518542 aan.sagepub.com
Tsuyoshi Takahashi, Masamitsu Murata and Makoto Tanaka
Figure 1. Computed tomography revealing the chest tube penetrating the right middle lobe, with an infiltrative shadow around the injury site.
An 81-year-old woman was admitted to our hospital with dyspnea on exertion. She had undergone aortic valve replacement 2 days earlier because of aortic stenosis. A right pleural effusion was detected on chest radiography. After confirming the location of pleural effusion by ultrasonography, an 18F chest tube was inserted through the 5th intercostal space on the anterior axillary line. Lung injury was suspected when the patient developed hemoptysis and blood gushed into the tube. Computed tomography revealed that the chest tube had penetrated the right middle lobe, and an infiltrative shadow appeared around the injury site (Figure 1). Video-assisted thoracoscopic surgery was performed to repair the injury. There was a wide adhesion in the right middle lobe, and the chest tube was placed around the right middle lobe. After removing the chest tube, the orifice in the right middle lobe (Figure 2) was closed using 4/0 polydioxanone II sutures. The patient recovered with an uneventful postoperative course. In this case, owing to the adhesion in the lung, the parenchyma appeared as an echo-free space on ultrasonography. This case emphasizes the importance of carefully following the correct technique while performing the widely used procedure for inserting a chest tube.
Figure 2. After removing the chest tube, the orifice (arrows) can be seen in the right middle lobe.
Funding This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.
Conflict of interest statement None declared.
Department of Thoracic Surgery, JR General Hospital, Tokyo, Japan Corresponding author: Tsuyoshi Takahashi, MD, Department of Thoracic Surgery, JR General Hospital, 2-1-3 Yoyogi, Shibuya-ku, Tokyo, 151-8528 Japan. Email: [email protected]
Downloaded from aan.sagepub.com at UNIV OF FLORIDA Smathers Libraries on November 15, 2015
