Elsevier

Human Pathology

Volume 19, Issue 5, May 1988, Pages 518-523
Human Pathology

Lung perforation complicating tube thoracostomy: Pathologic description of three cases

https://doi.org/10.1016/S0046-8177(88)80197-7Get rights and content

Insertion of a chest tube into the pleural space is standard therapy for a variety of pleural abnormalities. Three cases are described of lung perforation secondary to this procedure. In all three cases the tube had been inserted with the use of a trocar, and in two there were pleural adhesions in the vicinity of the puncture; in none was the perforation suspected clinically or considered to contribute to patient death. Pathologic features included one or two pleural holes continuous with a parenchymal tract of variable length. In one case, there was early epithelialization of the inner surface of the tract, suggesting that some of these may remain patent and be seen as incidental findings long after their formation. Two of the cases were identified among 18 patients who had had chest tubes inserted and came to autopsy over a similar period, implying that the incidence of the complication is greater than is generally appreciated. Reasons for this under appreciation are the lack or nonspecificity of clinical and radiographic findings and the ease with which perforation can be overlooked at autopsy.

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From the Department of Pathology, Montreal General and Montreal Chest Hospitals and McGill University, Montreal, Quebec, Canada.

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