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Rupture of the aorta due to a malpositioned tracheal cannula in a 4-month-old baby

L C Peres1, R C Mamede, F V de Mello Filho

  • 1Department of Pathology, Faculty of Medicine of Ribeiräo Preto, Ribeiräo Preto University Medical School, University of Säo Paulo, Brazil.

Insights

Tracheostomy complications, though common in children, can be severe. A rare case highlights a misplaced cannula causing fatal aortic and carotid artery rupture due to a false tract.

Area of Science:

  • Medicine
  • Surgery
  • Pediatrics

Background:

  • Tracheostomy is a common procedure, especially in pediatric patients.
  • Complications associated with tracheostomy can range from acute to chronic, some with severe outcomes.

Observation:

  • A rare case involving a pediatric patient with a tracheostomy is presented.
  • The tracheal cannula was found to be malpositioned, creating a false tract extending from the neck to the mediastinum.

Findings:

  • The malpositioned cannula led to necrosis and subsequent rupture of the aorta.
  • Necrosis and rupture of the left carotid artery also occurred, resulting in fatal hemorrhage.

Implications:

  • This case underscores the critical importance of precise cannula placement during tracheostomy.
  • It highlights a rare but catastrophic complication that can arise from malpositioning, emphasizing the need for vigilance in pediatric airway management.
  • The findings suggest a need for enhanced imaging or procedural checks to prevent such severe outcomes.

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