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Post-Tracheostomy Fistula Formation Between the Trachea and Left Common Carotid Artery in a Pediatric Patient with
Tsuyoshi Shiina1, Hirokazu Watanabe2, Junko Yoshimoto1
1Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University.
Insights
Improved survival in trisomy 18 increases tracheostomy needs. A case report details a fatal tracheoarterial fistula involving the left common carotid artery (LCCA) in a child with trisomy 18, emphasizing vascular anomalies.
Area of Science:
- Medical Case Reports
- Genetics
- Pediatric Surgery
Background:
- Long-term survival for individuals with trisomy 18 has improved.
- This demographic shift has led to an increased need for tracheostomy procedures.
- Trisomy 18 is associated with various congenital anomalies, including vascular abnormalities.
Abstract:
The long-term survival of individuals with trisomy 18 has improved, and the need for tracheostomy in this population has thus increased. We describe the case of a 3-year-old Japanese boy with trisomy 18 who developed a tracheoarterial fistula involving the left common carotid artery (LCCA). He underwent an emergency tracheostomy for respiratory failure secondary to pneumonia. Massive hemorrhage from the tracheostoma occurred on postoperative day 31, leading to his death. The autopsy revealed that the LCCA originated from the brachiocephalic trunk and coursed medially, forming a fistulous connection with the trachea. This case highlights the clinical importance of preoperative vascular mapping in patients with chromosomal abnormalities.
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