Selective intubation of left main bronchus

Selective intubation. This radiograph was performed immediately following a right thoracotomy for pleurodesis; the patient had a history of metastatic breast cancer with recurrent symptomatic right pleural effusions. The endotracheal tube appears malpositioned at first glance, but you will notice that there are two lumens – one which ends just above the carina and a second which ends in the left main bronchus (yellow arrow). This type of tube is inserted so that one-lung anaesthesia can be performed, while the other lung is allowed to deflate during the thoracotomy. Note also the right-sided chest tube (orange arrow), and the portacath, with its tip in the right atrium (red arrow).