Iatrogenic Horner's syndrome secondary to chest tube thoracostomy.

We report a 22-year-old male who underwent a left thoracostomy and left lower lobectomy for a shotgun wound of the left anterior chest. During surgery, two chest tubes were placed in the left hemithorax at the level of the first and second intervertebral spaces. On the 10th postoperative day, the patient developed a left-sided miosis and ptosis. The diagnosis of a left preganglionic Horner's syndrome was confirmed by pharmacologic testing. The Horner's syndrome was unchanged 3 months after discharge. We conclude that the chest tubes damaged the preganglionic sympathetic fibers of the left orbit resulting in this patient's Horner's syndrome.