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Ascaris worm in the intercostal drainage bag: inadvertent intercostal tube insertion into jejunum: a case report
© Mohite et al; licensee BioMed Central Ltd. 2010
Received: 11 August 2010
Accepted: 8 December 2010
Published: 8 December 2010
Inadvertent insertion of the intercostal tube into abdomen is not rare. It can present by different ways. In the present case an Ascaris worm crept into the intercostal drainage bag to reveal the false passage of the tube.
Pneumothorax is present in about one fifth of the blunt chest trauma cases. Insertion of an intercostal tube drainage is one effective treatment and significant morbidity can be avoided by prompt pleural decompression using proper techniques . Both ventral and lateral approaches are equally preferred by the clinicians and no statistically significant difference between the two approaches for functional malposition is observed . Inadvertent abdominal insertion of the intercostal tube is not rare but it is diagnosed immediately by absent air column movement in tube as well as with development of pneumoperitoneum and abdominal symptoms. Injury to the stomach or bowel may bring ingested or digested food particles into the chest tube . In present case, the inadvertent entry of chest tube into jejunal loop was concealed, may be, because of snug fitting of tube into jejunum which prevented leak of intestinal air and fluid into peritoneum. The air column movement was present in the tube as the proximal holes in the tube were in left chest. The drainage of bile was not apparent initially as it was mixed with more quantity of blood in chest. It was revealed only when an Ascaris worm made its way out through the tube.
Close observation of the chest tube drainage bag contents should be the routine practice.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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