TITLE:
A Fatal Arterio-Tracheal Fistula Post-Tracheostomy: A Case Report in a Sub-Saharan Setting
AUTHORS:
Yannick Mossus, Douglas Banga Nkomo, Serge Rowling’s Ngouatna, Lutresse Thome, Roger Christian Meva’a Biouélé, Leonel Christophe Atanga, Adèle-Rose Ngo Nyeki, David Mindja Eko, François Djomou, Alexis Ndjolo
KEYWORDS:
Arterio-Tracheal Fistula, Innominate Artery, Tracheostomy, Sub-Saharan Setting, Case Report
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.11 No.5,
September
28,
2022
ABSTRACT: 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.