Background. Use of small-bore pigtail catheter is a less invasive way for draining pleural effusions than chest tube thoracostomy. Methods. Prospectively, we evaluated efficacy and safety of pigtail catheter (8.5–14 French) insertion in 51 cases of pleural effusion of various etiologies. Malignant effusion cases had pleurodesis done through the catheter. Results. Duration of drainage of pleural fluid was 3–14 days. Complications included pain (23 patients), pneumothorax (10 patients), catheter blockage (two patients), and infection (one patient). Overall success rate was 82.35% (85.71% for transudative, 83.33% for tuberculous, 81.81% for malignant, and 80% for parapneumonic effusion). Nine cases had procedure failure, five due to loculated effusions, and four due to rapid reaccumulation of fluid after catheter removal. Only two empyema cases (out of six) had a successful procedure. Conclusion. Pigtail catheter insertion is an effective and safe method of draining pleural fluid. We encourage its use for all cases of pleural effusion requiring chest drain except for empyema and other loculated effusions that yielded low success rate. 1. Introduction Pleura is divided into a parietal layer which lines the inner aspect of the chest wall and a visceral layer which covers the lung and lines the interlobar fissures [1]. Pleural effusion is the abnormal accumulation of fluid in the pleural space. A pleural effusion is always abnormal and indicates the presence of an underlying disease. Approximately 1.4 million people in the United States develop a pleural effusion each year [2]. Normal liquid and protein enter pleura space from the systemic circulation and are removed by the parietal pleural lymphatics. Because the mesothelial boundaries are leaky, excess liquid can move across into the lower pressure (intrapleural), high-capacitance space and collect as a pleural effusion. These effusions can form based on disease of the pleural membranes themselves or disease of thoracic or abdominal organs [3]. Fluid collection within the pleural cavity can be assessed with clinical and radiological means. When pleural effusion is detected, the characteristics of the fluid (exudate or transudate) must be revealed using thoracocentesis [1]. Tube thoracostomy remains the standard of care for the treatment of pneumothorax and simple effusions in most hospitals [4]. Placement of a large-bore chest tube is an invasive procedure with potential morbidity and complications and therefore the use of small-bore pigtail catheter may be desirable [5]. The aim of this study was to
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