Chest tube perforation of esophagus following repair of esophageal atresia.

The two major acute thoracic complications of closed chest tube thoracostomy are pulmonary laceration and vascular compression. We have noted that closed chest tube thoracostomy can also perforate an esophageal anastomosis or myotomy site. Clinically, such a perforation produces a profuse discharge of gas and/or fluid through a chest tube positioned at the level of the anastomosis or myotomy site. Plain films demonstrate an accumulation of extrapleural gas and/or fluid adjacent to the distal portion of the chest tube. If untreated, these accumulations may form into an extrapleural abscess.