• N Hulde, M Köppen, M Gratzke, H Kisch-Wedel, P Brenner, and V Huge.
• Klinik für Anaesthesiologie, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland. Nikolai.Hulde@med.uni-muenchen.de.
• Anaesthesist. 2018 Jun 1; 67 (6): 448-451.

AbstractThe report describes the rare case of a periprocedural hemorrhage during percutaneous dilatation tracheotomy. In the final analysis, the innominate artery could be identified as the source of the hemorrhage. Particular attention must be paid to preprocedural evaluation of the puncture site and the procedure following unexpected hemorrhage. Continuation of the percutaneous tracheotomy, with only a clinical suspicion of a vascular injury while the bleeding source remained undetectable, seemed to be the most reasonable option. In this case the potentially life-threatening hemorrhage could be stopped and the elective treatment was completed. Therefore, because palpation of the neck cannot exclude life-threatening vascular aberrations with certainty, a preprocedural ultrasound examination of the anatomical features should be performed before carrying out a dilatation tracheotomy.

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