Iatrogenic bronchopleural fistula from a Dobhoff tube
A 50 year old obese female in the intensive care unit with chronic tracheostomy underwent a bed side Dobhoff tube placement with the stylette still in it. A chest radiograph was obtained to verify the placement of the tube.
Name all the findings on the radiograph. What went wrong?
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The tube had been advanced through the right lower lobe bronchus into the right pleural space and into the deep cardio phrenic sulcus. This is an iatrogenic pneumothorax.
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The feeding tube was taken out and a large bore chest tube was placed. There was good lung re-expansion. Fortunately for the patient the fistula likely sealed itself with just the chest tube in place which was removed one week later without recurrence of an air leak or pneumothorax.