[Fistula between the trachea and innominate artery--a rare complication following tracheostenosis treatment with silastic tubes].
BACKGROUND
Fistulas between the trachea and innominate artery are rare but devastating complications that usually occur following tracheotomies.


METHODS
One case a fistula after long-term treatment of a tracheal stenosis with an Montgomery silastic tube was analyzed. A literature review of the different strategies in diagnosis and treatment of this complication was undertaken.


RESULTS
In the present case, the fistula occurred after long-term treatment of tracheal stenosis with silastic tubes (Montgomery). Summarizing our experience with this case and a review of the literature, it can be concluded that: Fistulas most frequently occur following tracheostomy or tracheal reconstructive surgery. Frequent bronchoscopic examination during long-term treatment of tracheal stenosis with silastic tubes is essential. Even minor tracheal hemorrhage in such cases must be thoroughly examined. In case of fistula hemorrhage, the most effective treatment consists of direct local compression, best obtained with a well placed respiration tube.


CONCLUSIONS
Fistulas between the trachea and innominate artery constitute a rare but possible complication after tracheal stenosis treatment.
Grundmann
T
T
Universitäts-HNO-Klinik Hamburg-Eppendorf.
Brachtel
E
E
Kehrl
W
W
D000328:Adult; D016122:Brachiocephalic Trunk / Q000293:injuries*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D015607:Stents / Q000009:adverse effects; D014132:Trachea / Q000293:injuries*; D014135:Tracheal Stenosis / Q000628:therapy