Ghai Babita, Makkar Jeetinder Kaur, Bakshi Jayamanti, Rana Shelly, Singh Rana Sandip, Bhagat Sanjeev
Department of Anesthesia, Post Graduate Institute of Medical Institute Sciences and Research, Chandigarh, India.
Paediatr Anaesth. 2007 Jun;17(6):588-91. doi: 10.1111/j.1460-9592.2006.02176.x.
Tracheoarterial fistula (TAF) involves erosion through the tracheal wall into the innominate artery resulting in bleeding. It is a rare but lethal complication of tracheostomy. Mortality is 100% without operative interference. Even with appropriate management, a survival rate of only 14.3% has been reported. We report a case of TAF in a child, where rapid institution of resuscitative and operative measures resulted in survival. Initial temporary control of bleeding was achieved by hyperinflation of cuff. Computed tomography (CT) angiography confirmed the diagnosis. The damaged segment of the eroded artery was resected and ligated. This case highlights the role of early diagnosis and prompt aggressive therapy for management of this potentially lethal complication.
气管动脉瘘(TAF)是指气管壁被侵蚀穿破进入无名动脉导致出血。它是气管切开术一种罕见但致命的并发症。若无手术干预,死亡率为100%。即便采取恰当的治疗措施,据报道生存率也仅为14.3%。我们报告一例儿童气管动脉瘘病例,通过迅速采取复苏和手术措施使其得以存活。最初通过气囊过度充气实现了出血的临时控制。计算机断层扫描(CT)血管造影证实了诊断。对被侵蚀动脉的受损节段进行了切除和结扎。该病例凸显了早期诊断和迅速积极治疗在处理这种潜在致命并发症中的作用。