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Updated: Jan 29, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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[The devil is in the details: wrong side thoracic drainage].

M Aetou1, U Janssens2

  • 1Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital gGmbH Eschweiler, Dechant-Deckers-Str. 8, 52249, Eschweiler, Deutschland.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|February 7, 2019
PubMed
Summary

A chest tube was wrongly inserted into the healthy left lung instead of the diseased right lung due to misleading X-ray findings and an unclear examination. This case highlights the need for improved imaging accuracy and team protocols to prevent serious adverse events.

Keywords:
Chest tubeIntensive care unitPneumothoraxRadiologyWrong-site surgery

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Area of Science:

  • Medical Case Reports
  • Radiology
  • Thoracic Surgery

Background:

  • Spontaneous pneumothorax requires prompt chest tube insertion for lung re-expansion.
  • Accurate radiological interpretation is critical for correct device placement.
  • Patient history, including pulmonary fibrosis, can complicate clinical assessment.

Observation:

  • A case report details a chest tube incorrectly placed on the healthy left side for a right-sided spontaneous pneumothorax.
  • Misleading radiological findings, including a side-inverted chest X-ray, contributed to the error.
  • An inconclusive clinical examination in a patient with pulmonary fibrosis further complicated diagnosis.

Findings:

  • The incorrect chest tube placement was identified on a follow-up chest X-ray, revealing a serious adverse event.
  • Diagnostic errors in radiology and clinical assessment led to the malplacement.
  • The digital production of the chest X-ray was inverted, leading to side confusion.

Implications:

  • Emphasizes the critical need for accurate radiological image documentation and interpretation.
  • Highlights the importance of team training, bedside sonography, and checklists to prevent procedural errors.
  • Underscores the potential for severe patient harm from incorrect chest tube placement due to diagnostic challenges.