Medical devices in the thorax

Last revised by Mateusz Wilczek on 28 Dec 2023

Medical devices in the thorax are regularly observed by radiologists when reviewing radiographs and CT scans.

These devices are a common cause of artifacts and may trip the unweary, but in general, are recognized for what they are.

The following are more important to be recognized by the radiologist:

  • thoracostomy tubes

    • usually placed anterosuperiorly to drain pneumothorax, and posteroinferiorly to drain pleural effusion

    • a well-positioned tube should lie between the visceral and parietal pleura, and there should not be any kinking

    • to check the correct positioning, frequently AP and lateral views are required. A supplemental CT scan may also be performed.

    • should not enter the interlobar fissure, else it may be blocked 1; tip should not be within the lung parenchyma or subcutaneous tissue

    • all drain holes should be in the pleural cavity to ensure adequate drainage 5

  • pigtail catheter: used in empyema drainage

  • Heimlich valve: it is a one-way valve used for pleural space drainages, which prevents the return of gases or fluids into the pleural space

  • plombage: "ping-pong ball" plombage and wax plombage (historically used for tuberculosis, but no longer)

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