Iatrogenic bronchopleural fistula from a Dobhoff tube

Case contributed by Jayanth Keshavamurthy

Presentation

The patient is 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 years
Gender: Female

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

x-ray

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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