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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
1   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
2   Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
James H. Hertzog
1   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
2   Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Shirley Viteri
1   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
2   Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Nicholas B. Slamon
1   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
2   Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Further Information

Publication History

04 April 2018

15 August 2018

Publication Date:
15 September 2018 (online)

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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

Disclosure

None of the authors listed above had any real or perceived financial interest in relation to this case report.


 

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