• Demosthenes Makris, Medi Hatthabi, Arnaud Scherpereel, Jean-Jaques Lafitte, and Charles-Hugo Marquette.
• Clinique des Maladies Respiratoires, Hôpital Albert Calmette, Centre Hospitalier Régional Universitaire de Lille, 59037 Lille Cedex1, France. appollon7@hotmail.com
• Emerg Med J. 2007 Mar 1; 24 (3): e17.

AbstractA 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.

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