The “Fountain of Death”: A Case Series on  Tracheo-innominate Artery Fistula

Jason Lo; Marina  Mat Baki; Yeoh Xing  Yi; Nik Hisyam  Amirul; Zahirrudin  Zakaria

doi:10.31436/imjm.v20i2.727

The “Fountain of Death”: A Case Series on Tracheo-innominate Artery Fistula

Authors

Jason Lo Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre
Marina Mat Baki Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre
Yeoh Xing Yi Department of Otorhinolaryngology, Penang General Hospital, Malaysia
Nik Hisyam Amirul Department of Otorhinolaryngology, Penang General Hospital, Malaysia
Zahirrudin Zakaria Department of Otorhinolaryngology, Penang General Hospital, Malaysia

DOI:

https://doi.org/10.31436/imjm.v20i2.727

Keywords:

Tracheo-innominate artery fistula (TIF), Tracheostomy, Permissive hypotension,, Complications massive bleeding, death

Abstract

Tracheo-innominate artery fistula (TIF) is a very rare complication related to tracheostomy and has been reported in 0.7% of patients, but certainly is one of the most life-threatening conditions. It is of paramount importance to maintain a high index of suspicion in evaluating patients with TIF and to anticipate occurrence of massive haemorrhage even during simple procedures related to tracheostomy such as tube change. We report 3 cases of TIF, each with a unique and unsuspecting history of the condition and review the emergency protocol in arresting the bleeding. We’ve also highlighted the potential role of permissive hypotension with sedation in improving survival outcomes of patients with TIF.

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Published

01.04.2021

How to Cite

Lo, J., Mat Baki, M. ., Yi , Y. X. ., Amirul , N. H. ., & Zakaria , Z. . (2021). The “Fountain of Death”: A Case Series on Tracheo-innominate Artery Fistula. IIUM Medical Journal Malaysia, 20(2). https://doi.org/10.31436/imjm.v20i2.727

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Issue

Vol. 20 No. 2 (2021): IIUM Medical Journal Malaysia - April 2021

Section

Case Report

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