Iatrogenic bronchopleural fistula from a Dobhoff tube

Case contributed by Dr Jayanth Keshavamurthy

Presentation

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.

Patient Data

Age: 50
Gender: Female
X-ray

Name all the findings on the radiograph. What went wrong?

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. 

Case Discussion

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.

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Case information

rID: 43483
Case created: 13th Mar 2016
Last edited: 14th Mar 2016
Inclusion in quiz mode: Included

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