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Suprascapular Chest Tube Placement for Symptomatic Spontaneous Pneumothorax: The Forgotten Access Point
Sammy Onyancha1, Bardia Amirmiran1, Tanja Dieball1
1Department of Pulmonology St. Elisabethen Krankenhaus Frankfurt Germany.
Respirology Case Reports
|July 17, 2026
Summary
The suprascapular chest tube approach offers a safe alternative for managing apical pneumothorax when conventional methods are contraindicated. This technique successfully treated a patient with COPD and emphysema, demonstrating its clinical utility.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Devices
Background:
- Spontaneous pneumothorax frequently complicates advanced interstitial and emphysematous lung disease.
- Chest tube drainage is the standard treatment for pneumothorax.
- Conventional insertion sites (Bülau and Monaldi positions) have limitations and contraindications.
Purpose of the Study:
- To evaluate the safety and efficacy of the suprascapular approach for chest tube placement.
- To present a case where standard pneumothorax drainage sites were contraindicated.
Main Methods:
- A suprascapular (posterior apical) chest tube insertion was performed under local anesthesia.
- An 8Fr pigtail catheter was utilized for drainage.
- Continuous negative pressure was applied for pneumothorax evacuation.
Main Results:
- Successful evacuation of apical pneumothorax was achieved.
- The procedure was performed without complications.
- This approach was viable when lateral and anterior routes were contraindicated due to patient-specific factors.
Conclusions:
- The suprascapular approach is a safe and effective alternative for apical pneumothorax management in selected patients.
- It provides a viable option when conventional chest tube insertion sites are not feasible.
- This technique expands the armamentarium for treating spontaneous pneumothorax.
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