#Tracheo-innominate-fistula, a rare and often deadly complication of #Tracheostomy! Yellow arrow points to the tracheostomy stoma, black arrow points to the defect in the innominate (bracheocephalic) artery. The next photo shows a probe going through the defect in the innominate artery and out the tracheostomy stoma, confirming the connection between a large caliber artery and the trachea. The patient was noted to have sudden brisk bleeding from his mouth and tracheostomy tube, which was suspected to be arterial in origin. On #autopsy, this defect was noted!