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Fistula Between Innominate Artery and Trachea

Fistula Between Innominate Artery and Trachea Abstract FISTULA between the trachea and a large blood vessel has been a well recognized late complication of tracheostomy. In about 75% of cases, the trachea communicated with the innominate artery; in the remainder with the carotid artery, a thyroid artery, the innominate vein, or the aortic arch.1-10 Silen and Spieker,7 in 1965, described the first such patient to survive the bleeding episode, but unfortunately this patient died two weeks later from bronchopneumonia, presumably related to aspiration. The purpose of this paper is to record the first long-term survivor after massive hemorrhage from a fistula between the trachea and the innominate artery and to underscore the factors responsible for survival. Report of a Case A 14-year-old Negro girl was admitted to the hospital on April 9, 1966, with respiratory difficulty due to progressive muscular weakness of two years' duration. The exact nature of her underlying myoneurologic disease has not References 1. Clin, R.: Ulcération du tronc brachio-céphalique au 10e jour d'une trachéotomie , Ann Otolaryng 80:1003, 1963. 2. Davis, H.S.; Kretchmer, H.E.; and Bryce-Smith, R.: Advantages and Complications of Tracheostomy , JAMA 153:1156-1159, 1953.Crossref 3. Davis, J.B., and Southwick, H.W.: Hemorrhage as a Post-Operative Complication of Tracheostomy , Ann Surg 144:893-896, 1956.Crossref 4. Jarvis, J.F.: Vascular Hazards in Tracheostomy , J Laryng 78:781-784, 1964.Crossref 5. Lunding, M.: The Tracheostomy Tube and Post-Operative Complications , Acta Anaesth Scand 8:181-189, 1964.Crossref 6. Schlaepfer, K.: Fatal Hemorrhage Following Tracheostomy for Laryngeal Diphtheria , JAMA 82:1581-1583, 1924.Crossref 7. Silen, W., and Spieker, D.: Fatal Hemorrhage From the Innominate Artery After Tracheostomy , Ann Surg 162:1005-1012, 1965.Crossref 8. Thompson, S.G.: Hazards of Tracheostomy , Brit Med J 5499:1358, 1966.Crossref 9. Veress, L., and Romhanyi, I.: Fatal Hemorrhage From the Innominate Artery After Tracheotomy , J Laryng 79:462-465, 1965.Crossref 10. Welin, F.: Arteria Anonyma Blødning , Yng laeg 10:1079, 1964. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Fistula Between Innominate Artery and Trachea

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Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1968.01330210079014
Publisher site
See Article on Publisher Site

Abstract

Abstract FISTULA between the trachea and a large blood vessel has been a well recognized late complication of tracheostomy. In about 75% of cases, the trachea communicated with the innominate artery; in the remainder with the carotid artery, a thyroid artery, the innominate vein, or the aortic arch.1-10 Silen and Spieker,7 in 1965, described the first such patient to survive the bleeding episode, but unfortunately this patient died two weeks later from bronchopneumonia, presumably related to aspiration. The purpose of this paper is to record the first long-term survivor after massive hemorrhage from a fistula between the trachea and the innominate artery and to underscore the factors responsible for survival. Report of a Case A 14-year-old Negro girl was admitted to the hospital on April 9, 1966, with respiratory difficulty due to progressive muscular weakness of two years' duration. The exact nature of her underlying myoneurologic disease has not References 1. Clin, R.: Ulcération du tronc brachio-céphalique au 10e jour d'une trachéotomie , Ann Otolaryng 80:1003, 1963. 2. Davis, H.S.; Kretchmer, H.E.; and Bryce-Smith, R.: Advantages and Complications of Tracheostomy , JAMA 153:1156-1159, 1953.Crossref 3. Davis, J.B., and Southwick, H.W.: Hemorrhage as a Post-Operative Complication of Tracheostomy , Ann Surg 144:893-896, 1956.Crossref 4. Jarvis, J.F.: Vascular Hazards in Tracheostomy , J Laryng 78:781-784, 1964.Crossref 5. Lunding, M.: The Tracheostomy Tube and Post-Operative Complications , Acta Anaesth Scand 8:181-189, 1964.Crossref 6. Schlaepfer, K.: Fatal Hemorrhage Following Tracheostomy for Laryngeal Diphtheria , JAMA 82:1581-1583, 1924.Crossref 7. Silen, W., and Spieker, D.: Fatal Hemorrhage From the Innominate Artery After Tracheostomy , Ann Surg 162:1005-1012, 1965.Crossref 8. Thompson, S.G.: Hazards of Tracheostomy , Brit Med J 5499:1358, 1966.Crossref 9. Veress, L., and Romhanyi, I.: Fatal Hemorrhage From the Innominate Artery After Tracheotomy , J Laryng 79:462-465, 1965.Crossref 10. Welin, F.: Arteria Anonyma Blødning , Yng laeg 10:1079, 1964.

Journal

Archives of SurgeryAmerican Medical Association

Published: Mar 1, 1968

References