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Updated: Mar 27, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

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Complications of percutaneous thoracostomy in neonates and infants

R C Reed1, B L Waters2, J R Siebert3,4

  • 1Department of Pathology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|January 8, 2016
PubMed

Insights

Chest tube placement in infants can cause thoracic organ injury, particularly lung perforation. This risk may be underestimated, with diagnoses sometimes only found during autopsy.

Area of Science:

  • Pediatric surgery
  • Thoracic medicine
  • Neonatal care

Background:

  • Percutaneous thoracostomy tubes are common in pediatric patients.
  • The technique generally has a low complication rate.
  • Lung perforation by pigtail catheters is a rare but reported complication.

Purpose of the Study:

  • To investigate the incidence and characteristics of thoracic organ injury following percutaneous chest tube placement in neonates and infants.
  • To highlight potential underappreciation of this complication.

Main Methods:

  • Multi-center case series.
  • Inclusion of neonates and infants undergoing percutaneous chest tube placement between 2006 and 2015.
  • Review of medical records for thoracic organ injury.

Main Results:

  • Eleven patients experienced chest tube-related thoracic organ injury.
  • Lung lobe perforation was the most common injury, followed by injury to the pericardium and mediastinum.
  • Six injuries occurred during resuscitation; most tubes were pigtail catheters.

Conclusions:

  • Thoracic organ injury from percutaneous catheters may be more frequent than previously recognized.
  • Clinical and radiological signs of injury are often non-specific.
  • Diagnosis may be delayed, sometimes identified only at autopsy.
Abstract

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