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J Nippon Med Sch ; 79(4): 274-9, 2012.
Article in English | MEDLINE | ID: mdl-22976606

ABSTRACT

Tracheo-innominate artery fistula (TIF) is a serious, life-threatening complication following tracheostomy. We report a fatal TIF in a 15-year-old girl with Pelizaeus-Merzbacher disease. She received a tracheostomy for prolonged translaryngeal intubation due to acute respiratory failure without a trial of noninvasive ventilatory support before intubation. Severe hemorrhage from the TIF occurred 6 months after tracheostomy; immediate resuscitation failed. Antemortem fiberoptic bronchoscopy showed tracheal stenosis accompanied by granulation tissue, and postmortem examination revealed TIF with ulcerative granulation. Preventive intervention is required to avoid catastrophic TIF due to its high mortality rate. Moreover, to avoid prolonged translaryngeal intubation leading to tracheostomy, noninvasive ventilatory support before translaryngeal intubation, if applicable, is beneficial.


Subject(s)
Brachiocephalic Trunk/surgery , Pelizaeus-Merzbacher Disease/complications , Trachea/blood supply , Trachea/surgery , Tracheostomy/adverse effects , Vascular Fistula/etiology , Adolescent , Brachiocephalic Trunk/diagnostic imaging , Bronchoscopy , Fatal Outcome , Female , Granulation Tissue/pathology , Humans , Infant , Pelizaeus-Merzbacher Disease/diagnostic imaging , Pelizaeus-Merzbacher Disease/surgery , Radiography, Thoracic , Tomography, X-Ray Computed , Trachea/diagnostic imaging , Trachea/pathology , Vascular Fistula/diagnostic imaging
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