Complications after emergency tube thoracostomy: assessment with CT.

Abstract

To assess the spectrum of complications after emergency tube thoracostomy (TT) and show the role of computed tomography (CT) in detection of these abnormalities. CT scans, chest radiographs, and clinical data were reviewed in 51 patients (77 tubes) who underwent emergency TT after trauma. CT scans were analyzed for chest tube malposition (CTM) and persistent pneumo- or hemathoraces. The complication most often seen after emergency TT, as demonstrated with CT, was CTM (20 of 77 tubes [26%]). Only seven of the CTMs seen at CT were evident on chest radiographs. Two extrathoracic and 18 intrathoracic (five intraparenchymal, nine intrafissural) malpositioned tubes were seen at CT. Other findings included persistent pneumo-and hemathoraces in 16 patients. Patients undergoing emergency TT are at increased risk for complications. CTM is the most common abnormality and should be diagnosed promptly to prevent additional problems. CT is more useful than plain radiography for establishing a diagnosis.