Fig 12.

(left) Small pneumothorax post-pleurectomy at right apex (open arrow). Fluoroscopic guided needle puncture (white arrow) is being carried out. This unusual approach through the first intercostal space could damage subclavian vessels, which can be avoided by preliminary ultrasound examination of the needle path (arrowhead=suture material). (centre) Wire (arrow) is placed through the needle after aspiration of air. (right) Pigtail catheter coiled in pneumothorax and connected to underwater seal