Case Report: Tracheoinnominate Fistula Following Tracheal Resection and Reconstruction: A Rare and Life-Threatening Complication

Introduction Tracheal stenosis is a multifactorial condition, most often resulting from fibrotic tissue formation due to prolonged airway trauma. While non-surgical approaches can provide temporary or even curative outcomes, surgical resection and reconstruction remain the most effective and durable treatment. Despite major advances in tracheal surgery, life-threatening complications can still occur postoperatively. Methods We report a rare and severe postoperative complication—tracheoinnominate fistula (TIF) in a patient undergoing tracheal resection and reconstruction for post-intubation stenosis. Clinical data, imaging findings, intraoperative observations, and outcomes were reviewed. A brief literature review was conducted to contextualize the case. Results On postoperative day, the patient developed sudden massive hemoptysis and hemodynamic instability. Urgent surgical re-exploration revealed a fistulous connection between the trachea and the innominate artery. Hemorrhage control was achieved through ligation of the innominate artery and repair of the tracheal defect. Conclusion This report emphasizes the importance of vigilance, multidisciplinary care, and prompt intervention in the face of rare but devastating vascular complications.