Major aorto-pulmonary collateral arteries (MAPCAs)-Bronchial fistula presenting as tracheotomy bleed

Paul E. Johnson, Abtin Tabaee, Ingrid A. Fitz-James, Robert H. Pass, Lianne M. de Serres

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Tracheal hemorrhage is a common occurrence in pediatric patients with long-term tracheotomies. The majority of these events are related to self-limited etiologies, such as granulation tissue or suction trauma. Tracheo-arterial fistula, however, represents a frequently fatal form of tracheal hemorrhage that may initially be difficult to distinguish from other causes. Previous reports have described the pathophysiology, presentation and management of tracheo-arterial fistula involving the innominate artery. We describe a case of a 21-month-old male with a history of significant congenital cardiac malformations and chronic tracheotomy tube dependence who presented with intermittent, brisk bleeding from the tracheotomy tube. He was ultimately diagnosed with and treated for an arterio-bronchial fistula from a major aorto-pulmonary collateral artery. We review the etiology and management of this disorder.

Original languageEnglish (US)
Pages (from-to)1109-1113
Number of pages5
JournalInternational journal of pediatric otorhinolaryngology
Issue number6
StatePublished - Jun 2006
Externally publishedYes


  • Hemoptysis
  • Multiple aorto-pulmonary collateral arteries
  • Tracheotomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology


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