Pleuro-pericardial communication due to pigtail catheters in extreme preterm infants: Diagnosis and intervention.

Pneumothorax in preterm infants is associated with an increased risk of chronic lung disease, intraventricular hemorrhage and mortality. In mechanically ventilated preterm infants, for the management of tension pneumothorax if needle aspiration is not successful a thoracostomy is needed. In the last two decades management of tension pneumothorax has changed from the use of traditional chest tubes to percutaneous pigtail catheter thoracostomy (PPCT) as the most commonly used technique. When compared to placement of traditional chest tubes, PPCT is touted as being faster requiring, less analgesia and less training for proficiency and having fewer complications. There are only infrequent reports of complications with this procedure. Here, a rare complication, which previously has only been reported at autopsy, is described in an extreme preterm with prompt diagnosis and early management.