Application of Targeted Coronary Angiography in the Diagnosis of Sudden Cardiac Death / 法医学杂志

OBJECTIVES@#To diagnose coronary artery stenosis by using the postmortem computed tomography angiography (PMCTA), and to explore the diagnostic value of PMCTA in sudden cardiac death.@*METHODS@#Six death cases were selected, and the contrast medium iohexol was injected under high pressure through femoral artery approach with 5F pigtail catheter to obtain coronary image data and then the data was analyzed. The results of targeted coronary imaging and coronary artery calcium score (CaS) were compared with the results of conventional autopsy and histopathological examination.@*RESULTS@#The autopsy and histopathological examination of cases with coronary artery stenosis obtained similar results in targeted coronary angiography, with a diagnostic concordance rate of 83.3%. Targeted coronary angiography could effectively show coronary artery diseases, and the CaS was consistent with the results of conventional autopsy and histopathological examination.@*CONCLUSIONS@#Targeted coronary angiography can be used as an effective auxiliary method for conventional autopsy in cases of sudden cardiac death.

Evaluation of the effectiveness of pigtail catheter applying in single port video assistant thoracic surgery for pulmonary tumor: a study based on propensity score matching / 中华胸心血管外科杂志

Objective:To evaluate the effectiveness of pigtail catheter applying in single port video assistant thoracic surgery(VATS) for pulmonary tumor.Methods:A total of 441 patients undergoing single port VATS were obtained in this study. The patients were divided into chest-tube group and pigtail-catheter group. We used propensity score matching to match the patients 1∶1 and the clinical factors of the two groups were compared.Results:There were 143 patients in each group successfully matched by propensity score matching. The total drainage of 3 days after operation of pigtail-catheter group was significantly more than chest-tube group(375.49 ml vs. 285.03 ml, P<0.001). The pleural effusion on CT scan two weeks after surgery of pigtail-catheter group was significantly less than chest-tube group(131.77 ml vs. 178.84 ml, P=0.032). There was no significant difference between the two groups for the pain score, drainage days and inpatient days. Conclusion:Pigtail catheter can effectively improve the drainage of single port VATS, and there was no influence for the advantage of the surgery.

TREATMENT DIFFICULTIES WITH LIVER ABSCESS IN PREGNANCY A RARE CASE REPORTTREATMENT DIFFICULTIES WITH LIVER ABSCESS IN PREGNANCY A RARE CASE REPORT

Liver abscess in pregnancy is a rare entity and can be a life threatening condition. Here we present A case of amoebic liver abscess in 25 years old lady in of pregnancy, with highlights on treatmentthird trimester difficulties which we had faced in the management and timely intervention leads to good fetomaternal outcome

Prospective study of etiology of liver abscess and comparison of different ways of its management

Background: Liver abscess is a collection of purulent material in the liver parenchyma which can be due to bacterial, parasitic, fungal or mixed infection. It has become one of the most common communicable disease with much more prevalence in underdeveloped and developing countries. Two most common type of liver abscess are amoebic and pyogenic. Pyogenic liver abscess is more common in western world while amoebic liver abscess is more commonly found in third world countries, which are under developed, and more people living under lower socio economic conditions.Methods: A prospective study of 50 patients with clinical diagnosis of liver abscess admitted in the department of surgery B. R. D. Medical College Gorakhpur during a period of one year.Results: There was male predominance (98%) and most of the patient belongs to younger age group and low socio economics status. In amoebic liver abscess there was strong correlation with alcohol intake (66%).Conclusions: In our study most of the patients were group 21-30 years and the most common presenting symptom was right upper quadrant pain and fever. In most of the patients, the common hematological finding was mild anaemia with leucocytosis with altered LFT.

Assessment of outcome and complications of ultrasonography guided pigtail catheter drainage in management of liver abscess

Background: Liver abscess (LA) is defined as an encapsulated collection of suppurative material within the liver parenchyma. Liver abscesses are most commonly due to bacterial, amoebic or mixed infections. Less commonly these may be fungal in origin. Liver abscess are associated with mortality of up to 20% and are categorized into various types based on aetiology, of which amoebic (ALA) and pyogenic (PLA) liver abscess are major types. The objective is to evaluate and assess the response of percutaneous pigtail catheter drainage in treatment of liver abscess and to document the complications of liver abscess (LA).Methods: The study was conducted on patients who were admitted from casualty and outpatient department with a diagnosis of liver abscess (LA). 100 patients of LA were included in the study. They were divided into two groups. Group 1 consists of LA patients without associated complications and Group 2 consists of LA patients with associated complications like rupture, jaundice, IVC compression, persistent or recurrent LA.Results: There were 88% males and 12% were females in the study. 30% patients had complications. Out of them, 14 (46.6%) patients of LA presented with intra-peritoneal rupture. 12 (40%) with jaundice, 2 (6.7%) with rupture into pleural cavity and 2 (6.7%) patients had IVC compression. (70%) had involvement of right lobe while minimum patients (12.9%) had bilateral lobe involvement in group 1 and (10%) had involvement of left lobe of liver in group 2.Conclusions: Pigtail insertion and percutaneous catheter drainage (PCD) of abscesses, peritoneal or pleural cavity are safe procedures. PCD is a good alternative to open surgical drainage.

Complications and residual pleural thickening after intrapleural instillation of streptokinase with pigtail catheter drainage of tuberculous pleural effusion

Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. Residual pleural thickening (RPT) is observed in about 50 percent of patients even after proper treatment with ATT. Pleural fluid drainage either with simple aspiration or with intercostal drainage and addition of corticosteroids along with antitubercular drugs have not shown to influence the incidence of RPT. The present study was undertaken to study the complications and residual effects of tubercular pleural effusion on the patients during the follow up period following intrapleural streptokinase instillation.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received intercostal drainage without intrapleural streptokinase instillation. All the patients received standard daily anti TB regimen of 2HERZ/4HR for a total duration of six months. All the patients were followed up for a total duration of 1 year for evidence of any residual pleural thickening.Results: Majority of the patients were above 40 years of age (60%). The male to female ratio was 2.3:1. The major symptoms of the patients were, fever in 44 patients (88%), cough in 42 patients (84%), breathlessness in 33 patients (66%), loss of appetite in 25 patients (50%) and chest pain in 25 patients (50%). Most of the patients had ADA levels between 40-70IU/L (48%) and only 6% had ADA levels below 40IU/L. The incidence of residual pleural thickening in the study group was less as compared to the control group (2.36�49mm vs 9.28�50mm) (p <0.0001).Conclusion: Intrapleural streptokinase instillation with pigtail catheter drainage less number of complications associated with study group and is successful with the decreased incidence of residual pleural thickening during the follow up period.

Comparative Study In Management Of Hepatic Abscess Drainage Using Ultrasound Guided Needle Aspirations Versus Pigtail Catheter Placement.

Objective: The aim of this study was to compare the effectiveness of percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the management of hepatic abscess. Methods: The current study includes prospective randomized comparative study of 60 patients admitted in emergency and indoor department at tertiary health care centre, randomized into two groups- Percutaneous needle aspiration (PNA) & Pigtail catheter drainage (PCD). The effectiveness of hepatic abscess is based early recovery period, duration of hospital stay, and clinical improvement status. Results: The recovery rate was significantly improved in catheter drainage group. The analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of early recovery, clinical improvement and days to achieve a 50% reduction in abscess cavity size. Conclusion: Both PNA and PCD are safe methods of draining hepatic abscesses. However, PCD is more effective than PNA because it facilitates a higher success rate, reduces the time required to achieve clinical relief and supports a 50% reduction in abscess cavity size. However, among successfully treated patients, the outcomes of PNA are comparable with those of PCD.

Clinical observation of two surgical methods based on a new type of lacrimal canalicular anastomosis device / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the clinical effect of two surgical methods based on a new type of lacrimal canalicular anastomosis device.<p>METHODS:In this research, we observed eighty relative cases(80 eyes)of traumatic lower canalicular laceration and all clinical assessments were performed during and after operation. Two kinds of probes were used for lacrimal canalicular anastomosis. The elastic pigtail probe was used for double lacrimal canalicular intubation(experience group)and the straight probe was used for single lacrimal canalicular intubation(control group).<p>RESULTS: The average time of intubation was 12.1±3.7min in experience group and 21.2±5.5min in control group(<i>t</i>=8.68, <i>P</i><0.05), and the average time of total operations was 28.9±5.6min in experience group and 34.4±6.8min in control group(<i>t</i>=3.95, <i>P</i><0.05). The rates of anatomic and functional success were 88%(35 cases)and 90%(36 cases)in experience group and 82%(33 cases)and 90%(36 cases)in control group at 12mo after operation(<i>P</i>>0.05). There were 4 cases of epiphora and 5 cases of lacrimal stenosis in the experience group, and 4 cases of epiphora, 7 cases of lacrimal stenosis, 5 cases of skin scar, 2 cases of catheter displacement and 1 case of eyelid relaxation in the control group(<i>P</i>>0.05). The intraoperative penetration rate was 100% in both groups, and the false path was not observed in this study.<p>CONCLUSION: The two methods of lacrimal canalicular anastomosis have different advantages, and they are both effective and feasible therapies in clinic.

The clinical application of pigtail catheter thoracic closed drainage in the first diagnosed as spontaneous pneumothorax in adolescents / 中华胸心血管外科杂志

Objective To investigate the two kinds if thoracic cavity closed drainage contrast analysis and evaluate the pigtail catheter for treatment of spontaneous pneumothorax in adolescents.Methods This study included 53 adolescent patients with the first spontaneous pneumothorax in Huaihe Hospital of Henan University between January 2013 and December 2015.According to the different operation ways,they were divided into two groups:silicone tube and pigtail catheter group.The following post-operative data was evaluated:pain,subcutaneous emphysema,drainage time,hospital stay,new drain insertion,and wound healing at the site of insertion.Results There were 32 patients in the silicone tube group and 21 ones in the other group.The data revealed a significantly reduced the operation time and pain in the pigtail catheter group compared to the chest tube group(P ＜ 0.05).However,no statistical differences in success rate,postoperative hospital stay and complications incidence were found between the 2 groups.Conclusion Compared to common chest tube,the employment of pigtail catheter in the adolescent patients with pneumothorax significantly reduces the operation time and pain.Nevertheless,no statistically significant differences were discovered in success rate,postoperative hospital stay and the incidence of complications between the two corresponding groups.Thus pigtail catheter is competent in terms of closed thoracic drainage in adolescents who are the first diagnosed as spontaneous pneumothorax.

Effects of two catheters on thoracic close drainage / 现代临床护理

Objective To explore the effect of pigtail and silicone catheters on thoracic close drainage. Methods Sixty-one patients undergoing closed thoracic drainage hospitalized in our department from June 2013 to November 2016 were divided into the control group (n=31) and observation group (n=30). The control group was treated with closed pleural drainage using silicone catheter and the observation group using pigtail catheter. The two groups were compared in respect of drainage effect nursed the same. Results The extubation time, wound healing time of the observation group were all significantly shorter than those of the control group ( P<0.05). The pain score, complication rate and hospitalization cost were all significantly lower as well ( P < 0.05). Conclusions The pigtail catheter is more effective in the treatment of pneumothorax. It can alleviate pains, reduce the complication rate and surgical scar, and improve patient's satisfaction.

A Prospective Comparative Study to evaluate drainage of liver abscess by 20 Fr PVC catheter versus 10 Fr pigtail catheter.

Background: Large liver abscess requires drainage by pigtail catheter. These catheters tend to get blocked frequently and thus takes long period of time to completely drain. So we wanted to study whether inserting a large bore catheter would drain the abscess faster thus decreasing the stay and requirement of antibiotics. Aim: To study the effectiveness of wide bore PVC catheter (20 Fr) in drainage of large peripheral liver abscess as compared to the use of pigtail catheter (10 Fr). Methods: The study was prospective comparative study done at a tertiary care hospital. Over a period of 22 months, 60 patients of amoebic liver abscess were assigned to undergo pigtail catheter drainage by 10 Fr. Versus wide bore 20 Fr PVC catheter drain and the outcomes were compared. Results: Use of wide bore (20 Fr) PVC catheter significantly decreased the duration of treatment, led to faster drainage of abscess and decreased incidence of recurrence in large amoebic liver abscess, as compared to pigtail catheter drainage by the standard 10 Fr pigtail catheter. Conclusion: 20 Fr PVC catheter is safe and efficacious for evacuating large solitary peripheral liver abscesses and should be preferred to narrow bore pigtail catheter.

Ascariasis as a cause of hepatic abscess: A report of 3 cases.

We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

A prospective study of USG guided pigtail catheter drainage in management of liver abscess.

Background: Treatment of the liver abscess of any etiology has evolved in the recent years. Percutaneous drainage of liver abscess has been an important advancement in the treatment of pyogenic liver abscesses. Aim: to evaluate and assess response, morbidity and complication rates of percutaneous pig tail catheter drainage in treatment of liver abscess. Methods: During a period of 27 months, 25 patients with liquefied liver abscess ≥5x5 cm underwent percutaneous drainage under sonographic guidance. Results: 18 had solitary abscess, while 7 had multiple abscesses. Pigtail catheters of various sizes (10 F or 12 F) were introduced in these patients using the Seldinger technique. The volume of pus drained ranged from 150 to 400 ml, while the period of catheter drainage ranged from 6 to 17 days. Complications were minor and included catheter blockage in 2 patients and tract pain in 8 patients. There was no mortality associated with this procedure. This study shows a success rate of 96% (successful treatment in 24 out of 25 patients). Conclusion: Percutaneous catheter drainage of liver abscesses is successful with a low morbidity and mortality and should be the first line of management in liquefied moderate to large sized liver abscesses.

Nefrolitectomía percutánea "Tubeless" con catéter pigtail versus catéter ureteral externalizado por una noche: estudio comparativo, prospectivo y randomizado / Comparison of tubuless percutaneous nephrolithothotomy with pigtail catheter versus one nigth externalized ureteral catheter: comparative, prospective and randomized study

La nefrolitectomía percutánea (NLP) es una técnica establecida para el tratamiento de nefrolitiasis de gran tamaño que finaliza dejando una nefrostomía para hemostasia, drenaje y facilitar una eventual revisión. Nuestro grupo publicó recientemente un estudio prospectivo y randomizado que demostró la factibilidad y seguridad de realizar NLP “tubeless” (sin nefrostomía y con catéter pigtail) en un grupo seleccionado de pacientes (sin litiasis residual ni sangrado intra operatorio significativo, con acceso percutáneo único y tiempo operatorio menor a 2 horas).Objetivo: Comparar el uso de catéter ureteral tipo pigtail versus catéter ureteral externalizado por 24 horas en pacientes sometidos a NLP “tubeless”. Métodos: Sesenta y ocho pacientes sometidos a NLP ¨tubeless” fueron prospectivamente randomizados para el uso de catéter pigtail (Grupo 1) o catéter ureteral externalizado por una noche (Grupo 2). Se evaluó el dolor pos operatorio, estadía hospitalaria, caída del hematocrito y desarrollo de hematomas perirrenales objetivados por tomografía axial computarizada no contrastada. Para el análisis estadístico un p value <0,05 fue considerado significativo. Resultados: Los grupos fueron comparables en edad, distribución de sexo, índice de masa corporal y carga litiásica. No difirieron en dolor pos operatorio ni incidencia de hematomas. El Grupo 1 tuvo una estadía hospitalaria y una caída del hematocrito significativamente mayor. Conclusión: Los resultados sugieren que ambas conductas son factibles y seguras. La mayor estadía hospitalaria del Grupo 1 y la posterior necesidad de cistoscopia para retirar el catéter pigtail favorecen el uso de catéteres ureterales externalizados. Además se validan los criterios utilizados para la aplicación de la técnica tubeless en NLP...

Percutaneous nephrolithotomy (PNL) is an established technique for the management of big renal calculi that finishes leaving a nephrostomy tube to provide hemostasia, drainage and access for a second look when needed. We have recently published a prospective and randomized study demonstrating the feasibility and safety of performing “tubeless” PNL (without nephrostomy and leaving a pigtail catheter) in a selected group of patients (no significant residual lithiasis nor significant intraoperative bleeding, single access and less of 2 hours of surgery).Objective: Compare the use of pigtail catheter versus night-externalized ureteral catheter in patients subjected to “tubeless” PNL. Methods: Sixty eight patients undergoing “tubeless” PNL were prospectively randomized for the use of pigtail catheter (Group 1) or 24 hours-externalized ureteral catheter (Group 2).Postoperative pain, hospital stay length, hematocrit drop and evidence of peri-renal hematomas in non-enhanced computarized tomography were evaluated. For statistical analysis a p value <0.05 was considered significant. Results: Groups were similar in age, sex distribution, body mass index and stone burden. No differences in postoperative pain or incidence of hematomas were observed. Group 1 had a longer hospital stay and a greater hematocrit drop. Conclusion: These results suggest that both alternatives are feasible and safe. The longer hospital stay in Group 1 and the further need of cystoscopy to remove the pigtail catheter favors the use of 24 hours-externalized ureteral catheter. In addition, we validate our intraoperative criteria for performing “tubeless” PNL...

The Effect of Punctoplasty with Pigtail Probe for Canalicular Intubation in Patients with Punctal Obstruction

PURPOSE: To assess the surgical results of a punctoplasty with insertion of a silicone tube using a pigtail probe for the management of acquired punctal obstruction. METHODS: The medical records of 61 patients who underwent an operation for the management of punctual obstruction were reviewed. After punctal dilation, fluorescein dye disappearance test was performed to evaluate its efficacy. In the case of no functional delay after punctal dilation, three-snip punctoplasty with a silicone tube using a pigtail probe was performed. In the case of a functional delay, three-snip punctoplasty with a silicone tube into the nasolacrimal duct was performed. RESULTS: The surgical success over 1 year was 39.1% in patients who underwent only three-snip punctoplasty, 79.2% in patients who underwent a three-snip punctoplasty with a silicone tube insertion into the nasolacrimal duct, and 85.7% in patients who underwent a three-snip punctoplasty with canalicular intubation using a pigtail probe. CONCLUSIONS: The use of a pigtail probe for canalicular intubation together with a three-snip punctoplasty is useful to prevent the recurrence of punctal obstruction.

Simple Method of Silicone Tube Intubation with Pigtail Probe and Maintenance for Lacrimal Canalicular Repair

Silicone tube intubation with pigtail probe is one of the popular methods for lacerated canalicular repair. One of the major problems in this method is the difficulty of silicone tube insertion into the lumen of the lacerated canaliculus due to the large tip diameter of silicone tube itself, Also, long-term maintenance of silicone tube may cause conjunctival irritation and cosmetic problems. We could minimize the difficulty of silicone tube insertion by suture connection between a round-tip eyed pigtail probe and a silicone tube tip prepared like syringe needle tip for patients with lower lacrimal canalicular laceration. We could keep the silicone tube safely and effectively by inserting the anastomosis site of closed loop system into the upper punctum.

Efficacy of Pigtail Catheter Drainage in Patients with Thoracic Empyema or Complicated Parapneumonic Effusion / 결핵

BACKGROUND: The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. MATERIALS AND METHODS: 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. RESULTS: Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion(9.4+/-5.25 days vs. 19.2+/-9.42 days, p<0.05) and the duration of hospital admission after catheter insertion(15.9+/-10.45 days vs. 38.6+/-11.46 days, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD(11.1+/-7.35 days vs. 19.2+/-9.42 days, p<0.05, 17.5+/-9.17 days vs. 38.6+/-11.46 days, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. CONCLUSION: In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.

Treatment of ureteral stricture with three indwelling double pigtail stents / 中国微创外科杂志

Objective To assess the feasibility of intracavitary drainage using three equally-sized double pigtail stents in the treatment of ureteral stricture. Methods Placement of three identical double pigtail stents in ureters for indwelling for 10～12 weeks was carried out in 27 cases of ureteral stricture from March 2000 to June 2003. Results The patients were followed for 2～24 months, with a mean of 18 months. No lumbar distending pain or fever occurred after the removal of the drainage in 26 cases, with the IVP examination indicating patency drainage and no ureteral stricture. Re-examination of IVP 6 months after the surgery found no improvement of hydronephrosis in 1 case. The overall success rate was 96% (26/27). Conclusions Intracavitary drainage using three equally-sized double pigtail stents in the treatment of ureteral stricture is feasible.

Correction of Incidentally Migrated Pigtail Stent in Pancreatic Pseudocyst using Polypectomy Snare / 대한소화기내시경학회지

Endoscopic drainage of pancreatic pseudocysts is a new nonsurgical treatment modality. Among the cystogastrostomy and stent related complications, proximal migration of stent is rare and the correction of inserted stent into a pseudocyst is very difficult. We report a correction of an incidentally inserted pigtail stent into pseudocyst using a polypectomy snare.

Comparison of Therapeutic Effects and Complications between Pigtail Catheter and Conventional Tube Thoracotomy for Pneumothorax in Neonates

PURPOSE: Pneumothorax develops frequently as a complication of respiratory diseases and in the course of management in newborn. We compared therapeutic effects and complications of conventional tube thoracotomy and Pigtail catheter inserted by modified Fuhrman's technique for pneumothorax in neonates. METHODS: We reviewed the clinical records of 22 infants with pneumothorax treated with tube thoracotomy and 14 infants with Pigtail catheter, admitted at Kangnarn Sacred Heart Hospital and ChunCheon Sacred Heart Hospital between Jan 1995 and Jul 1998. Sex ratio(13: 9 vs. 7: 7), gestational age(32.7+/-4.3 vs. 31.5+/-5.5 wks), birth weight(1906+/-1025 vs. 1836+/-1128 g) and the incidence of tension pneumothorax(68% vs. 59%) and spontaneous pneumothorax(18% vs. 35%) were not significantly different between two groups. RESULTS: The tube insertion time(5.1+/-4.8 vs. 4.3+/-4.1 days of life), duration of tube insertion(168+/-150 vs. 86+/-78 hrs), duration of mechanical ventilation after tube insertion (8.6+/-6.9 vs. 5.8 and mortality during tube insertion(65% vs. 43%) were not significantly different between tube thoracotomy group and Pigtail catheter inserted group. The complications such as hemothorax and pulmonary hemorrhage were found in 7 cases in tube thoracotomy group but none in Pigtail catheter inserted group. CONCLUSION: Conventional chest tube insertion for pneumothorax can often be traumatic, but Pigtail catheter insertion is safer and easier. Percutaneous placement of Pigtail catheters may be a useful alternative to the conventional method of thoracotomy tube placement in small infants.