An Emergency Case: A Successful Anesthetic Management of Aorta-Trachea Fistula

Abstract

This report describes 19 year old male with a case with tracheal necrosis and the presence of ascendan aortic fistula with the sign of massive hemoptysis which is diagnosed intraoperatively, although preoperative chest CT has not demonstrated the findings. This emergency case report was to demonstrate the possible ways ofintraoperative management in similar desperate situations. On the first hand, laparotomy is done as planned previously to extract omentum for the support of suspected tracheal injury. Second part of the operation continued with sternotomy and emergently one lung ventilation and later extra corporal circulation. At the end of the operation, the patient was transferred to ICU. He has been discharged from hospital without any haemodynamic or neurological complication. In this case priority is maintaining oxygenation. The inflammatory changes in the surgical anatomic region must be carefully considered. Postoperative ventilation parameters and side effects of positive pressure ventilation make ECMO devices mandatory.