Demographics:
25 years old, Male
Indication:
Spontaneous pneumothorax, followup
Findings
Chest radiograph
- Thoracostomy tube overlies the left lung apex with a wire extending through the tip of the tube
- Moderate-sized left pneumothorax
- Small left pleural effusion
- Patchy left basilar opacification
- Chain sutures overlie the left lung apex
- Small amount of subcutaneous emphysema in the left chest wall
CT
Chest
- Left thoracostomy tube courses along the outer rib margin, external to the thoracic cavity, with tip just superficial to the intercostal muscles in the upper back
- Moderate-sized left pneumothorax
- Small left pleural effusion
- Dependent atelectasis in the left lower lobe
- Linear suture line in the left lung apex, possibly related to prior resection of pleural blebs/bullae
Upper abdomen
- No acute findings
MSK
- Left chest wall subcutaneous emphysema
Diagnosis
Malpositioned chest tube
Sample Report
Malpositioned left thoracostomy tube which courses external to the costal margin.
Moderate-sized left pneumothorax.
Small left pleural effusion.
Discussion