Abstract
A Rare and Fatal Complication of Tracheostomy: Tracheo-Innominate Fistula, A Case Report and Literature Review
Highlights
The tracheo-innominate fistula (TIF) is a fistulous communication between the trachea and the innominate artery
In 1980s, the risk of injury of a large vessel by a tracheostomy cannula was estimated at 2% [1]
We report a case of TIF in a 5-year-old girl in whom surgical management by immediate sternotomy allowed her survival
Summary
The tracheo-innominate fistula (TIF) is a fistulous communication between the trachea and the innominate artery. A classic but rare complication, affecting 1% of patients with tracheostomy tube (1,2) It causes massive intratracheal hemorrhage which immediately causes a double hemodynamic and respiratory distress. We report a case of TIF in a 5-year-old girl in whom surgical management by immediate sternotomy allowed her survival. We discuss through this case and a review of the literature the physio-pathological, clinical, therapeutic and preventive aspects of this life-threatening complication. Many factors may predispose to the development of TIF including a low placement of tracheostomy (below the third tracheal ring), prolonged overpressure of the cuff resulting in local necrosis, excessive anterior concavity of the cannula or its repeated mobilizations [4]. The patient died due to worsening of her neurological, hemodynamic and respiratory status
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