What are possible complications of a tube thoracostomy?

Updated: Feb 24, 2020
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Nader Kamangar, MD, FACP, FCCP, FCCM  more...
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Minor complications of thoracostomy tube placement such as unresolved/reaccumulation of pneumothorax or misplacement of the tube (too deep/kinked) are common and approach approximately 30%. [12]

Improper placement is a possible complication; various placements and resolutions are as follows:

  • Horizontal (over the diaphragm) - Acceptable for hemothorax; should be repositioned for pneumothorax (See the image below.)

    The chest tube is angulated, overlying the diaphra The chest tube is angulated, overlying the diaphragm.
  • Subcutaneous - Must be repositioned

  • Placed too far into the chest (against the apical pleura) - Should be retracted

  • Placed into the abdominal space - Should be removed

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