Progressive iatrogenic pneumothorax from incorrectly connected Heimlich valve

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Follow up chest X-ray to assess pneumothorax.

Patient Data

Age: 60 years
Gender: Female

Iatrogenic pneumothorax from port placement.

Iatrogenic tension pneumothorax from erroneous attachment of the Heimlich valve to the chest tube.

Blue-coloured end of the Heimlich valve attaches to the tube coming from the patient.

Case Discussion

On physical exam hyper-resonance of the left lung field was noted when compared to the right, with no lung sounds auscultated on the left side when compared to the right side.  

The patient's pigtail catheter was also examined at this time; the Heimlich valve was noted to be placed in reverse with the pigtail catheter obstructed, therefore preventing gas from escaping.  

The Heimlich valve was re-connected to the chest drainage set with wall suction with gas bubbles present after connection.

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Case information

rID: 44381
Case created: 19th Apr 2016
Last edited: 14th Nov 2017
Inclusion in quiz mode: Excluded
Institution: Augusta University

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