Catastrophic vertebral artery and subclavian artery pseudoaneurysms caused by a fishbone: A case report

Abstract

BACKGROUND Fishbone is the most common esophageal foreign body and tends to migrate after piercing the esophagus to nearby structures. Vascular injury around the esophagus is a serious complication and has a high mortality rate, especially in the case of multiple vascular injuries. CASE SUMMARY We report an extremely rare case of successive vertebral artery and subclavian artery pseudoaneurysms caused by swallowing a fishbone in a previously healthy 29-year-old female. She was transferred to the emergency department of our hospital because of hemorrhagic shock due to a vertebral artery pseudoaneurysm. We successfully managed the vertebral artery pseudoaneurysm with endovascular stent implantation and the patient's vital signs as well as hemodynamics once became stable. However, the patient died of the second subclavian artery pseudoaneurysm occurring within a short time, which was thought be related to the obvious displacement of the fishbone in the mediastinum. CONCLUSION Surgery and endovascular stent implantation may be the best choice for treating such complications. Early removal of the fishbone is of great significance in improving the survival of such patients.