Tension pneumothorax after placement of a tunneled pleural drainage catheter in a patient with recurrent malignant pleural effusions.

A case of tension pneumothorax developed after placement of a tunneled pleural catheter for treatment of malignant pleural effusion in a patient with advanced lung cancer. The catheter placement was carried out by an experienced operator under direct ultrasound guidance, and the patient showed immediate symptomatic improvement with acute decompensation occurring several hours later. Possible mechanisms for this serious complication of tunneled pleural catheter placement are described, and potential strategies to avoid or prevent it in future are discussed.