What is the most common complications of pneumothorax treatments?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Misdiagnosis is the most common complication of needle decompression. If a pneumothorax but not a tension pneumothorax is present, needle decompression creates an open pneumothorax. Alternatively, if no pneumothorax exists, the patient may develop a pneumothorax after the needle decompression is performed. Additionally, the needle may lacerate a lung, which, although rare, can cause significant pulmonary injury or hemothorax. If the needle is initially placed too medially to the sternum, needle decompression may cause a hemothorax by lacerating the inferior set of intercostal vessels or the internal mammary artery.

Damage to the intercostal neurovascular bundle and lung parenchymal injury can occur following thoracostomy tube placement, especially if trocars are used for placement, and there is an increased risk of postoperative bleeding after lung transplantation for medical pleurodesis and surgery (length of hospital stay not affected). [68]

Accidental disconnection and malpositioning of Heimlich valves can complicate an attempted outpatient treatment of pneumothorax via pigtail catheter.

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