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A 36 year-old woman was taken to an Emergency Department following an MVA. A diagnosis of a right-sided hemothorax was made and a chest tube was inserted with immediate return of blood. The patient was then transferred to a trauma center where, upon arrival to the ED, the following chest x-ray was obtained (notice location of chest tube):



The patient's chest tube was located partially in the liver parenchyma (it turned out the chest tube was not necessary as the patient had only a small pulmonary contusion). The patient was taken to the operating room where the chest tube was removed; the bleeding stopped spontaneously. There were no deleterious effects.

Cases such as this one emphasize the importance of blunt dissection and examining the pleural space with a finger prior to chest tube insertion.