Tracheoinnominate artery fistula: a rare and often fatal complication of indwelling tracheostomy tubes.
Fistula formation between the innominate artery and the trachea is a rare but potentially catastrophic complication after tracheostomy. Although surgery is the definitive treatment of tracheoinnominate artery fistula, the responsibility for making the proper diagnosis and stabilizing the patient before surgery often falls on the personnel in the emergency department. We describe the emergency department management of a 14-year-old girl with a tracheoinnominate artery fistula. A discussion of the risk factors, diagnostic considerations, and emergency department management strategies of tracheoinnominate artery fistula is presented.
Thorp
Andrea
A
Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA 92354, USA. lbrownmd@aol.com
Hurt
Thomas L
TL
Kim
Tommy Y
TY
Brown
Lance
L
D000293:Adolescent; D016122:Brachiocephalic Trunk / Q000293:injuries*; D016887:Cardiopulmonary Resuscitation; D015505:Chest Tubes; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D005402:Fistula / Q000209:etiology*; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology*; D006489:Hemostatic Techniques; D006801:Humans; D007022:Hypotension / Q000209:etiology; D002534:Hypoxia, Brain / Q000150:complications; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D016156:Respiratory Tract Fistula / Q000209:etiology*; D013610:Tachycardia / Q000209:etiology; D014132:Trachea / Q000293:injuries*; D014133:Tracheal Diseases / Q000209:etiology*; D014139:Tracheostomy / Q000009:adverse effects* / Q000295:instrumentation