CTICasesIntraparenchymal Pigtail Chest Tube Placement for Large Pneumothorax
[...]. Intraparenchymal Pigtail Chest Tube Placement for Large Pneumothorax. CTICases. Published October 8, 2026. https://cticases.com/c/gafbc
Imaging findings
A patient with back pain had a very large pneumothorax. After a pigtail drain was placed, the pneumothorax got smaller, but the pigtail never formed a curl on the frontal or lateral radiographs. CT, taken after the tube had been pulled back and repositioned, shows the catheter within the lung and a small tract from the original placement. The drain was replaced, and the new pigtail curled properly.
Key takeaways
A pigtail catheter in the pleural space, an abscess, or a collection should be able to curl. If it does not curl, suspect that it is in a tract within soft tissue or lung, even if the pneumothorax is improving. Ask the operator whether the tube became fixed and would not move. Intraparenchymal placement is not uncommon with small-bore drains placed quickly, for example during a large pneumothorax or trauma.
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