Tracheoinnominate Artery Fistula Formation in a Child with Long-Term Tracheostomy Dependence

Jigar C. Chauhan; James H. Hertzog; Shirley Viteri; Nicholas B. Slamon

doi:10.1055/s-0038-1672153

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2019; 08(02): 096-099
DOI: 10.1055/s-0038-1672153

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Tracheoinnominate Artery Fistula Formation in a Child with Long-Term Tracheostomy Dependence

Jigar C. Chauhan

¹Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States

²Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States

,

James H. Hertzog

¹Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States

²Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States

,

Shirley Viteri

¹Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States

²Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States

,

Nicholas B. Slamon

¹Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States

²Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States

› Author Affiliations

Abstract

We report a fatal tracheoinnominate artery fistula (TIF) in a 13-year-old female patient with long-term tracheostomy tube dependence due to chronic respiratory failure. Thirteen years after placement of her tracheostomy tube, the patient experienced two separate episodes of sentinel bleeding prior to a fatal hemorrhagic event. Diagnostic evaluation after the sentinel events was mostly nonconclusive. This case highlights the risk of TIF in pediatric age group, even years after initial tracheostomy tube placement, and the need for a high index of suspicion for TIF when children present with unexplained tracheal bleeding.

Keywords

tracheoinnominate artery fistula - tracheostomy - sentinel bleed

Full Text

References

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