Pigtail Drainage of Iatrogenic Pneumothorax or Hemothorax: Is a Sufficient Procedure?

Mohamed Gamal Sweed; Ali Abd Elwahab; Amr Ibrahim Abd Elaal; Mahmoud Hasabelnabi Abdelrazik

Mohamed Gamal Sweed Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assuit, Egypt
Ali Abd Elwahab Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assuit, Egypt
Amr Ibrahim Abd Elaal Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assuit, Egypt
Mahmoud Hasabelnabi Abdelrazik Department of General Surgery, Faculty of Medicine, Assiut University, Assuit, Egypt

Keywords: Thoracic Catheters, Iatrogenic Disease, Pneumothorax, Hemothorax, Chest Tube

Abstract

Background: Pigtail catheters, originally used by cardiologists to drain chronic pericardial effusions, have been adapted for pleural drainage. This study aimed to evaluate the effectiveness of pigtail catheterization as an alternative to chest tube in the management of iatrogenic pneumothorax and hemothorax.

Methods This prospective interventional study included 50 adult patients (>18 years) diagnosed with iatrogenic pneumothorax (Group A, n=25) or iatrogenic hemothorax (Group B, n=25).). All patients underwent clinical evaluation, including history taking, clinical examination, imaging procedures [chest CT and chest x-ray], and laboratory investigations.

Results: Group A had a significantly shorter hospital stay than Group B (P < 0.001). Regarding catheter-related complications, Group B had a significantly higher failure rate (P < 0.001). Univariate analysis revealed that hemothorax, chronic liver disease, central venous line insertion, and true cut biopsy from a central mass were significant risk factors for failure of the pigtail catheter.

Conclusion: Pigtail catheter is more efficient in the management of iatrogenic pneumothorax than hemothorax. It is preferred to initially apply conventional chest tube in the latter to avoid the high failure rate of these small catheters.