Early haemorrhage from brachiocephalic trunk as a complication of tracheostomy

A 27-year-old patient suffered injuries to the facial bones and brain contusion in a traffic accident. On the third day after the accident the patient was admitted to an intensive care unit in view of increasing respiratory failure. Tracheostomy was performed for prolonged controlled respiration. On the 6th day after tracheostomy the patient died from a sudden massive hemorrhage from the tracheostomy site. Autopsy findings showed that the direct cause of death was injury to the brachiocephalic trunk communicating with a focus of tissue necrosis in the tracheal wall. The authors stress the early development of this complication and the necessity of the earliest possible commencement of intensive care in cases of injuries to the facial bones.