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July 1965

Delayed Fatal Hemorrhage After Tracheotomy

Author Affiliations


From the Department of Internal Medicine, Baylor University College of Medicine. Fourth-year student, Baylor University College of Medicine (Mr. Willerson and Assistant Professor of Medicine and Director, Medical In-patient Service, Ben Taub General Hospital (Dr. Fred).

Arch Intern Med. 1965;116(1):138-141. doi:10.1001/archinte.1965.03870010140018

FATAL HEMORRHAGE as a delayed complication of tracheotomy has rarely been reported. In 1924 Schlaepfer discussed this event in relation to patients who had undergone tracheotomy for laryngeal diphtheria.1 The bleeding in those instances developed several days to months after the surgical procedure. It was apparently unrelated to the presence or absence of the tracheal cannula and presumably resulted from rupture of an aneurysm that formed as a consequence of an operative injury to, and subsequent development of necrotizing inflammation within, the wall of a large artery or vein. Not until 32 years later did Davis and Southwick 2 call attention to another mechanism of delayed fatal hemorrhage after tracheotomy, namely, pressure-induced erosion of the cannula through the tracheal wall into the innominate artery. Death of their two patients occurred within two and five weeks of operation, respectively. The type of complication described by these authors deserves wider