Horner's syndrome: a delayed complication after thoracostomy tube removal.

PURPOSE: Description of a complication from tube thoracostomy.

METHODS

Case report from experience at an Air Force tertiary care hospital in a 50-year-old female smoker undergoing left upper lobectomy for lung cancer.

RESULTS

Horner's syndrome resulted 18 hours after removal of an apical thoracostomy tube.

CONCLUSIONS

Horner's syndrome caused by tube thoracostomy is a rare but real complication. One should avoid placing the tip of the tube in the medial thoracic apex with the intent of avoiding second-order sympathetic chain pathways. As evidenced by our patient with a delayed onset of presentation, malpositioned tubes should be repositioned before symptoms develop. Long-term prognosis is poor once Horner's syndrome develops.