Objective:

To report a rare case of a malpositioned pigtail chest tube identified during flexible bronchoscopy in a pediatric patient with cystic fibrosis and acute respiratory failure.

Approach:

• Method: label
• Method: text

Key Findings:

• A left-sided pigtail chest tube was malpositioned in the lingula, identified during bronchoscopy.
• The patient developed tension pneumothorax after removal of the chest tube, necessitating placement of a second tube.

Interpretation:

This case emphasizes the need for careful evaluation of chest tube placement and the importance of a multidisciplinary approach in managing complex pediatric patients.

Limitations:

• The case is based on a single patient experience, limiting generalizability to broader pediatric populations.
• There is limited literature on similar occurrences in pediatric patients.

Conclusion:

The identification of a malpositioned chest tube during bronchoscopy underscores the need for thorough evaluation in critically ill pediatric patients.