Tracheoesophageal fistula and tracheo-subclavian artery fistula after tracheostomy.

Tracheoesophageal fistula and tracheo-arterial fistula are both uncommon but life-threatening complications after a tracheostomy. The most common source of a major hemorrhage is from the tracheo-innominate artery fistula. Most tracheo-arterial fistulas occur within the first 3 weeks after tracheostomy. We describe a very rare case of a patient who developed both a tracheoesophageal fistula and massive hemorrhage from a tracheo-left subclavian artery fistula 4 months after a tracheostomy procedure.