Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve.
A 3 1/2-year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae.
Nahum
E
E
Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tiqva. enahum@netvision.net.il
Ben-Ari
J
J
Schonfeld
T
T
Horev
G
G
D000208:Acute Disease; D015505:Chest Tubes / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010791:Phrenic Nerve / Q000293:injuries*; D012133:Respiratory Paralysis / Q000209:etiology*