Abstract
We present the case of a patient who developed a bronchopleural fistula, which was treated with the use of a chest drain with application of suction. The patient significantly deteriorated clinically and developed a tension pneumothorax. After some delay, the wall suction unit was found to be blocked, thereby creating a closed system and causing a pneumothorax under tension. We discuss the safe application of suction to chest drains with particular reference to the use of the three-bottle system.
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