Combined tracheoinnominate artery fistula and tracheoesophageal fistula: A very rare complication of indwelling tracheostomy tube

Abstract

Tracheoinnominate artery fistula (TIF) is a serious complication of tracheostomy. If untreated, it could be life-threatening. The emergency approach to the condition that includes prompt diagnosis, rapid control of bleeding with a clear airway, and operation with or without interruption of the innominate artery are the most important factors influencing patient outcome. Tracheoesophageal fistula (TEF) is another complication of tracheostomy. In association with compromised quality of life, this condition is really hard to be treated. We report a case of combined TIF and TEF in a 27-year-old man with quadriplegia who suffered a car accident but was successfully managed with interruption and ligature of the innominate artery repair of trachea.

Tratamento endovascular de fístula tronco arterial braquiocefálico-traqueal: relato de caso e revisão de literatura

“…6 Trauma to the anterior wall of the trachea, caused by the caliber of the cannula used for tracheostomy, by its being positioned in contact with the tracheal wall, and by pressure exerted by the cuff, may result in an ischemic process, inflammation and ulceration with transmural necrosis of the anterior trachea, involving adjacent structures such as the brachiocephalic trunk. 6,7 Additionally, hyperextension of the neck and poor positioning of the cannula can also cause trauma to mucosa and are thus factors that may trigger development of TIF. 8 The initial approach in these cases is hyperinflation of the tracheostomy cuff or endotracheal tube, after protection of the airway.…”