Bicakcioglu, M.Demircan, S.Yucel, A.Ozer, A. B.2024-08-042024-08-0420221128-3602https://doi.org/10.26355/eurrev_202205_28758https://hdl.handle.net/11616/100655OBJECTIVE: There are no reports of tracheomediastinal fistula development after tracheostomy. CASE REPORT: A 72-year-old female patient with post acute COVID-19 was transferred to our intensive care unit. After two unsuccessful weaning attempts, a tracheostomy was performed at hospitalization on day 32. The patient's body mass index was 35 kg/m2 and she had a narrow neck anatomy. A percutaneous tracheostomy was performed using the Griggs method without any problems. Pneumothorax, pneumomediastinum, subcutaneous emphysema, and hemorrhage were not observed. Twenty-two days after the tracheostomy, the patient developed subcutaneous emphysema and experienced a sudden decrease in oxygen saturation. Bedside anterior-posterior chest X-ray did not detect pneumothorax and a tracheoesophageal fistula was found via esophageal endoscopy. A tracheomediastinal fistula was observed just below the cannula distal end via computed tomography. CONCLUSIONS: There are multiple reasons why a tracheomediastinal fistula could develop after tracheostomy. Therefore, this condition should be considered in cases of sudden subcutaneous emphysema and oxygen deterioration following tracheostomy.eninfo:eu-repo/semantics/closedAccessTracheomediastinal fistulaTracheostomyComplicationCOVID-19Article269337433763558709110.26355/eurrev_202205_287582-s2.0-85130225582Q2WOS:000832946400039Q2