Fatal
bleeding in patients with tracheostomy is an uncommon incident, in the order of
0.1% to 1% of cases. It is secondary in 70% of cases to the innominate artery
fistula in the tracheal lumen. The fistula is generally created after the
necrosis of tracheal rings. The incriminated factors are the type of cannula
used, the site of tracheal opening below the 3rd tracheal ring, tracheal
infections and the proximity of the innominate artery to the tracheal axis. The
outcome of this incident is fatal in most cases. We report the case of a
59-year-old patient with a tracheostomy on the 11th day of his admission to
intensive care for severe head trauma secondary to a road accident. On the 22nd
day of his admission, the occurrence of a cataclysmic and fatal haemorrhage
through the tracheostomy tube evoked an arterio-tracheal fistula of the innominate
artery.
References
[1]
Kaneko, S., Uchida, K., Karube, N., Kasama, K., Minami, T., Cho, T., et al. (2020) Tracheo-Innominate Artery Fistula with Continuous Bleeding Successfully Treated through the Suprasternal Approach: A Case Report. Journal of Cardiothoracic Surgery, 15, Article No. 41. https://doi.org/10.1186/s13019-020-1080-y
[2]
Deguchi, J.O., Furuya, T., Tanaka, N., Nobori, M., Seki, Y., Nomura, Y., et al. (2001) Successful Management of Tracheo-Innominate Artery Fistula with Endovascular Stent Graft Repair. Journal of Vascular Surgery, 33, 1280-1282. https://doi.org/10.1067/mva.2001.114997
[3]
Singh, N., Fung, A. and Cole, I.E. (2007) Innominate Artery Hemorrhage Following Tracheostomy. Otolaryngology-Head and Neck Surgery, 136, 68-72. https://doi.org/10.1016/j.otohns.2006.10.042
[4]
Moujahid, A., Belhaj, A. and Haimeur, C. (2009) Innominate Artery Tear after Tracheostomy. Canadian Journal of Anesthesia, 56, 621-622. https://doi.org/10.1007/s12630-009-9112-z
[5]
Jones, J.W., Reynolds, M., Hewitt, R., et al. (1976) Tracheo-Innominate Artery Erosion: Successful Surgical Management of a Devastating Complication. Annals of Surgery, 184, 194-204. https://doi.org/10.1097/00000658-197608000-00011
[6]
Quinio, P., Foon, L.Y., Mouline, J. and Braesco, J. and de Tinteniac, A. (1995) Ulcération du tronc brachio-céphalique par une canule de trachéotomie. Annales Françaises d’Anesthésie et de Réanimation, 14, 296-299. https://doi.org/10.1016/S0750-7658(95)80010-7
[7]
Gray, H., Warwick, R., et al. (1973) Gray’s Anatomy. 35th Edition. Vol. 621, Longman, Edinburgh, 16.
[8]
Kbrte, W. (1879) Vber einige seltenere Nachkrank-heiten, nach der Tracheotomie wegen Diph-theritis. Langenbecks Arch Klin Chir Ver Dtsch Z Chir, 24, 238.
[9]
Gouéta, A., Oubian, S, Sanou, E., et al. (2020) Complications de la trachéotomie en ORL au Burkina Faso. Jaccr Africa, 4, 359-365.
[10]
Itiere, O., Otiobanda, G. and Ondzotto, G. (2014) La trachéotomie au CHU de Brazzaville. Revue Africaine de Chirurgie et Spécialités, 7, 11-14.
[11]
Praveen, C.V. and Martin, A. (2007) A Rare Case of Fatal Haemorrhage after Tracheostomy, Annals of the Royal College of Surgeons of England, 89, W6-W8.
[12]
Komatsu, T., Sowa, T., Fujinaga, T., Handa, N. and Watanabe, H. (2013) Tracheo-Innominate Artery Fistula: Two Case Reports and a Clinical Review. Annals of Thoracic and Cardiovascular Surgery, 19, 60-62. https://doi.org/10.5761/atcs.cr.12.01889
[13]
Iodice, F., Brancaccio, G., Lauri, A., et al. (2007) Preventive Ligation of the Innominate Artery in Patients with Neuromuscular Disorders. European Journal of Cardio-Thoracic Surgery, 31, 747-749. https://doi.org/10.1016/j.ejcts.2006.12.028
[14]
Arola, M.K. (1981) Tracheostomy and Its Complications. A Retrospective Study of 794 Tracheostomized Patients. Annales Chirurgiae et Gynaecologiae, 70, 96-106.
[15]
Grant, C.A., Dempsey, G., Harrison, J., et al. (2006) Tracheo-Innominate Artery Fistula after Percutaneous Tracheo-Stomy: Three Case Reports and a Clinical Review. British Journal of Anaesthesia, 96, 127-131. https://doi.org/10.1093/bja/aei282
[16]
Maeda, M., Kubo, A., Watanabe, M., et al. (2013) A Case of Tracheo-Innominate Artery Fistula after Tracheostomy. Japanese Journal of Neurosurgery, 22, 141-145. https://doi.org/10.7887/jcns.22.141
[17]
Patel, M.R., Cannon, T.Y. and Shores, C.G. (2011) Chapter 242. Complication of Airway Devices. In: Tintinalli, J.E., Stapczynski, J.S., Ma, O.J., Cline, D.M., Cydulka, R.K., Meckler, G.D., Eds., Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7th Edition, The McGraw-Hill Companies, New York, 1594-1595.
[18]
Yogo, A., Komori, M., Yano, Y., et al. (2017) A Case of Tracheo-Innominate Artery Fistula Successfully Treated with Endovascular Stent of the Innominate Artery. Journal of General and Family Medicine, 18, 162-164. https://doi.org/10.1002/jgf2.37
