Haemothorax after pig-tail catheter removal in a patient with primary spontaneous pneumothorax

A case of haemothorax is described which occurred after the removal of a small pig-tail chest tube (8.5 F) that was inserted in the second intercostal space in the mid-clavicular line, for primary spontaneous pneumothorax management. The patient was successfully resuscitated and 0.85 l of blood was aspirated. There was no evidence for pre-existing haemothorax, no metal instrument was used and no precipitating factor was present. Thus, it is possible that bleeding was due to a tear of a vessel proximal to the second intercostal space during pig-tail catheter removal by a "grapple-hook" mechanism. Whether a pig-tail catheter in itself carries an additional risk of complications compared with other catheter types is questionable. However, this report highlights the potential danger that accompanies pig-tail drain insertion into the second intercostal space in the mid-clavicular line, and suggests that insertion in other sites is technically easy and potentially safer for pneumothorax drainage.