Nonexpanding pneumothorax despite double intercostal drainage tubes

Abstract

Pneumothorax is one of the most common emergencies encountered in day-to-day pulmonary practice. Early diagnosis and prompt intervention will reduce morbidity as well as mortality. The mainstay of treatment involves tube thoracostomy and drainage of pneumothorax in all except the mild cases. Proper technique and ascertaining correct tube position with follow-up imaging ensure successful lung expansion. We share the case of a gentleman who presented with nonexpansion of lung despite inserting 2 intercostal drainage tubes for the management of pneumothorax. Imaging with computed tomography thorax revealed both tubes to be coiled within the chest wall without entry into pleural space, thereby accounting for failed reexpansion. This case stresses the importance of following a structured evaluation in cases of nonexpanding lung after tube thoracostomy for pneumothorax.