Current Thoracic Surgery 2024 , Vol 9 , Issue 1
Catastrophic injuries caused by tube thoracostomy with trocar: a series of nine cases
Gizem Keçeci Özgür1,Dilara Gürsoy2,Ufuk Çağırıcı2,Ali Özdil2,Tevfik Ilker Akçam2,Ayşe Gül Ergönül2,Kutsal Turhan2
1Thoracic Surgery Clinic, Yüksekova State Hospital, Hakkari, Turkey
2Department of Thoracic Surgery, Ege University School of Medicine, Izmir, Turkey
DOI : 10.26663/cts.2024.006 Viewed : 363 - Downloaded : 107 Background: Tube thoracostomy is a procedure that is frequently used in thoracic surgical practice. However, in certain circumstances, it may lead to serious complications during or soon after the procedure. Herein, we report a series of tube thoracostomies causing life-threatening intrathoracic and intraabdominal injuries.

Materials and Methods: This case series consisting of nine cases with serious organ and vascular injuries after tube thoracostomy between 2014 and 2021 are presented and the possible causes are discussed. The indications for tube thoracostomy were empyema, COVID pneumonia-related pneumothorax, traumatic pneumothorax, tracheal rupture related-hydropneumothorax during nasogastric tube application, and pleural effusion due to malignancy. A trocar was used in all patients for tube thoracostomy.

Results: Malpositioned thoracic drains included five pulmonary parenchymal lacerations and pulmonary artery, spleen, liver and stomach injuries; one of each.

Conclusions: In the light of these cases, all the procedures and the faults that caused those embarrassing complications have been reviewed honestly. Lessons learned from these events such as avoiding the use of trocars, and CT evaluation before the procedure may also help to prevent such complications in the future. Keywords : malposition, chest tubes, injuries, tube thoracostomy