Yogo Aoi, Komori Masafumi, Yano Yudai, Fujita Koji, Sando Eiichiro, Kotani Mitsuhisa, Sugimura Hiroshi, Ochi Atsushi, Moody Sandra, Yaegashi Makito
General Internal Medicine Kameda Medical Center Kamogawa Chiba Japan.
Cardiovascular Surgery Kameda Medical Center Kamogawa Chiba Japan.
J Gen Fam Med. 2017 May 2;18(4):162-164. doi: 10.1002/jgf2.37. eCollection 2017 Aug.
Tracheo-innominate artery fistula (TIF) is a rare but life-threatening complication of tracheostomy. We describe a 44-year-old man who was admitted for a pressure ulcer infection with a third tracheostomy in place. He showed massive hemoptysis from the TIF, followed by cardiopulmonary arrest. The cuff of the tube was hyperinflated; however, even a slight movement of the tube resulted in recurrent massive hemorrhage. Thus, an endovascular stent graft was placed. Our case shows that sentinel bleeding may be found prior to TIF, and an endovascular repair can be a lifesaving temporizing option, when the hemorrhage was not controlled by hyperinflating the cuff of the tube.
气管无名动脉瘘(TIF)是一种罕见但危及生命的气管切开术并发症。我们描述了一名44岁男性,因压疮感染入院,已行第三次气管切开术。他出现了由气管无名动脉瘘导致的大量咯血,随后发生心肺骤停。气管套管的气囊过度充气;然而,即使套管有轻微移动也会导致反复大量出血。因此,放置了血管内支架移植物。我们的病例表明,在气管无名动脉瘘发生之前可能会出现前驱性出血,当通过过度充气气管套管气囊无法控制出血时,血管内修复可能是一种挽救生命的临时选择。