Tracheo-innominate artery fistula in a laryngectomized patient.
Tracheo-innominate artery fistula is a rare but usually fatal complication of tracheostomy or intubation. To our knowledge, this complication has been reported following laryngectomy only in two patients. A 45-year-old woman with hypopharynx carcinoma developed tracheo-innominate artery fistula one month after total laryngopharyngoesophagectomy, as a complication of permanent tracheostomy, induced by the erroneous use of a 12-mm diameter silver tracheostomy cannula. With a median sternotomy, the innominate artery was reconstructed with Gore-Tex vascular graft interposition and separated from the trachea by a pedicled pericardial patch. Unfortunately, the patient sustained intermittent postoperative hemorrhages due to mediastinitis and died on the 15th day. After this tragic result, our attention was focused on both prevention of tracheo-innominate artery fistulas and methods of preventing and dealing with hemorrhages.
Sengör
Gani Atilla
GA
Nişantaşi ENT Group, Istanbul, Turkey. dr_atilla@yahoo.com
Aydin
Omer
O
D001807:Blood Vessel Prosthesis; D016122:Brachiocephalic Trunk / Q000293:injuries* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D017809:Fatal Outcome; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007582:Jejunostomy; D007825:Laryngectomy; D008480:Mediastinitis / Q000209:etiology; D008875:Middle Aged; D010611:Pharyngectomy; D019106:Postoperative Hemorrhage / Q000209:etiology; D016156:Respiratory Tract Fistula / Q000209:etiology* / Q000601:surgery; D014133:Tracheal Diseases / Q000209:etiology* / Q000601:surgery; D014139:Tracheostomy / Q000009:adverse effects* / Q000295:instrumentation