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Vol. 58. Issue 10.
Pages 716 (October 2022)
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Vol. 58. Issue 10.
Pages 716 (October 2022)
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Horner Syndrome as a Complication of Pleural Drainage
Valentina Alicia Rebolledo Navarretea, Hernán Luis Canalea,b, Alejando Gabriel Da Lozzoc, Horacio Matías Castrob,
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a Servicio de Medicina Interna, Hospital Italiano de San Justo Agustín Rocca, Argentina
b Sección de Neumonología, Hospital Italiano de Buenos Aires, Argentina
c Sección de Cirugía Torácica, Hospital Italiano de Buenos Aires, Argentina
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We report the case of a 19-year-old male patient with a history of left spontaneous pneumothorax 6 months previously who was admitted to the adult emergency department for a second spontaneous pneumothorax event. As the pneumothorax was recurrent, a left video-assisted thoracoscopy was performed with pulmonary wedge resection at the dystrophic lung apex and mechanical abrasion pleurodesis. A pleural drain connected to a −20cmH2O continuous suction system was subsequently placed. On the third day, the patient developed eyelid ptosis, anhidrosis, and unilateral left myosis (Fig. 1A), with no evidence of any other motor or sensory neurological focus. Chest X-ray showed pleural drainage in the left vertex near the region of the stellate ganglion (Fig. 1B). The case was interpreted as Horner syndrome caused by irritation of the stellate ganglion by the drainage tube. The chest tube was partially withdrawn, and the clinical picture resolved after 5 days.

Fig. 1.

(A) Eyelid ptosis and myosis of the left eye. (B) Chest X-ray: the tip of the pleural drainage tube is seen at the left lung apex (red arrow).


Horner syndrome due to pleural drainage has an incidence of less than 1%.1 It is associated with proximity of the tube to the stellate ganglion in the lung apex. It usually resolves after withdrawing or moving the chest tube.2


We have no sources of funding for the development of the manuscript.

Conflict of interests

We have no conflict of interests related directly or indirectly to the contents of this paper.

Appendix A
Supplementary data

The following are the supplementary data to this article:

S.O. Kaya, S.T. Liman, L.S. Bir, G. Yuncu, H.R. Erbay, S. Unsal.
Horner's syndrome as a complication in thoracic surgical practice.
Eur J Cardio-Thorac Surg, 24 (2003), pp. 1025-1028
D.T. Thomas, T.E. Dagli, G. Kiyan.
Horner's syndrome as a rare complication of tube thoracostomy: case reports and review of literature.
J Pediatric Surg, 48 (2013), pp. 1429-1433
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