PAEA Surgery End Of Rotation (EOR) Practice Exam

What is a major complication associated with inserting a chest tube?

1. Pneumothorax

2. Puncture of liver or spleen

3. Hypotension

4. Hyperventilation

The correct answer is: Puncture of liver or spleen

The major complication associated with inserting a chest tube is puncture of the liver or spleen. This complication can occur particularly when the chest tube is placed in the lower chest or abdominal area, where the liver and spleen are anatomically positioned. Proper technique and knowledge of anatomy are essential to minimize the risk of visceral injury during the procedure. When a chest tube is inserted, particularly in cases of suspected pleural effusion or pneumothorax, the potential for inadvertent puncture of surrounding structures increases, especially if the operator is not aware of variations in anatomy or fails to use imaging guidance when necessary. This highlights the importance of careful procedural planning and execution to avoid such complications. Being aware of these risks helps practitioners ensure patient safety and improve outcomes. In context, while pneumothorax is a serious concern, particularly when the lung is inadvertently punctured during tube placement, it is not a complication of the insertion process itself like visceral organ puncture. Hypotension and hyperventilation are not directly related to the chest tube placement procedure itself, making them less pertinent in this case.