Pulmonary/Critical Care Medicine Fellow, State University of New York, Buffalo, USAl
Received date: August 11, 2015; Accepted date: August 14, 2015; Published date: August 18, 2015
Citation:Rajany VD (2015) Pigtail in Bronchus. J Pulm Respir Med 5: i020. doi:10.4172/2161-105X.1000i1020
Copyright: © 2015 Rajany VD. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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A 55-year-old male was admitted to the Intensive Care Unit for hypoxemic respiratory failure secondary to healthcare associated pneumonia. The patient had diffuse bilateral interstitial infiltrates on initial chest radiograph. Sputum cultures have been persistently negative and he remained ventilator dependent with high oxygen requirements despite treatment with broad-spectrum IV antibiotics for 2 weeks. He underwent an open lung biopsy of the right middle and lower lobe. Day 4 post-operatively, his pneumothorax has not resolved. A pigtail catheter was inserted into the anterior 2nd intercostal space without difficulty. Post procedure imaging showed the catheter crossing the lung parenchyma and extending into the right main bronchus. The pigtail catheter was immediately removed and a new chest tube was placed. Follow up imaging showed re-expansion of the right lung and his chest tubes were eventually removed. The lung biopsy results revealed acute and organizing diffuse alveolar damage. Supportive management was continued and he was eventually weaned to minimal ventilator settings (Figures 1-6).