Presentation
Advanced COPD and silicosis, high O2 demand. Treated for bilateral pleural effusion with chest drainage. Suspected displacement of the right tube.
Patient Data
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One side hole of the right chest tube is displaced in the soft tissues, with resultant emphysema.
Left chest tube (note also subcutaneous emphysema) and right subclavian CVC in situ. ETT removed since prior exam. Bilateral enlarged hila with patchy airspace opacities in line with advanced silicosis, concomitant pneumonia possible. Predominantly apical, bilateral bullous emphysema. Pulmonary vascular engorgement and septal thickening in line with CHF. Prior recent non-displaced fracture of the left clavicle unchanged.
Case Discussion
Assessing side hole position of chest tubes is important (even when not directly asked), as extrapleural position can jeopardize the success of drainage.