Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4981
Peer-review started: June 5, 2020
First decision: July 29, 2020
Revised: August 8, 2020
Accepted: August 29, 2020
Article in press: August 29, 2020
Published online: October 26, 2020
Processing time: 142 Days and 24 Hours
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.
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.
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.
Core Tip: Fishbones are the most common esophageal foreign bodies. In rare cases, swallowed fishbones can penetrate the wall of the esophagus and cause catastrophic damage to the blood vessels around the esophagus. This serious complication has a high mortality rate. No prior case of vertebral artery and subclavian artery pseudoaneurysms due to migration of a swallowed fishbone in the very short term has been described. This case highlights the importance of finding and removing the fishbone as soon as possible and the combined use of surgery and endovascular stent implantation to treat such complications.