What is the most common site for chest tube malposition?

The most common site for chest tube malposition is the pleural fissure. When chest tubes are inserted, especially in emergency situations, there can be a tendency for the tube to slip into the fissures of the lungs rather than properly entering the pleural space. This can lead to inadequate drainage of pleural effusions or pneumothoraces, as the tube may not be positioned where it can effectively remove air or fluid from the pleural cavity.

The presence of pleural fissures means there are potential spaces where a chest tube might misplace, particularly if anatomical variations are present or if the tube is not angled correctly during insertion. This misplacement can also happen due to the movement of the patient or changes in their respiratory status after the tube has been placed.

The other options, while possible sites of complications or concerns during chest tube placement, are not as common for malposition. The pulmonary hilum is a complex area with major vascular and bronchial structures, which can complicate placement but is less frequently the location of a misdirected tube. The costophrenic angle and diaphragm have specific clinical considerations but do not correlate with malposition as frequently as the pleural fissure. Thus, understanding the anatomy and potential issues surrounding chest