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Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve
E Nahum1, J Ben-Ari, T Schonfeld
1Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tiqva. enahum@netvision.net.il
Abstract:
A 3 1/2-year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae.