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Review Article| Volume 13, ISSUE 2, P331-341, May 2003

Tracheoinnominate fistula: diagnosis and management

  • James S Allan
    Correspondence
    Corresponding author. James S. Allan, MD, Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Blake 1570, 55 Fruit Street, Boston, MA 02114
    Affiliations
    Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Blake 1570, 55 Fruit Street, Boston, MA 02114, USA

    Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
    Search for articles by this author
  • Cameron D Wright
    Affiliations
    Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Blake 1570, 55 Fruit Street, Boston, MA 02114, USA

    Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
    Search for articles by this author
      Tracheoinnominate fistula (TIF) is an uncommon, life-threatening complication that typically occurs when a tracheostomy tube erodes into the posterior aspect of the innominate artery. Although TIF occurs most commonly after tracheostomy, it has also been reported following other procedures in this anatomic region, including tracheal resection and tracheal stenting. As with all infrequent surgical complications, it is essential for the clinician to maintain a high index of suspicion for TIF when evaluating a patient with any amount of peristomal hemorrhage or hemoptysis. It is equally important that physicians who care for patients at risk for TIF have a clear understanding of the emergency management and operative correction of this frequently fatal complication.
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