Huang W, Zhang GQ, Wu JJ, Li B, Han SG, Chao M, Jin K. Catastrophic vertebral artery and subclavian artery pseudoaneurysms caused by a fishbone: A case report. World J Clin Cases 2020; 8(20): 4981-4985 [PMID: 33195670 DOI: 10.12998/wjcc.v8.i20.4981]
Corresponding Author of This Article
Kai Jin, MD, Attending Doctor, Department of Radiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. 21118139@zju.edu.cn
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2020; 8(20): 4981-4985 Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4981
Catastrophic vertebral artery and subclavian artery pseudoaneurysms caused by a fishbone: A case report
Wei Huang, Guang-Qiang Zhang, Jian-Jun Wu, Bin Li, Shu-Gao Han, Ming Chao, Kai Jin
Wei Huang, Guang-Qiang Zhang, Jian-Jun Wu, Bin Li, Shu-Gao Han, Ming Chao, Kai Jin, Department of Radiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Author contributions: Huang W and Jin K reviewed the literature and drafted the manuscript; Zhang GQ interpreted the imaging findings and drafted the manuscript; Li B obtained patient consent and reviewed the manuscript; Wu JJ reviewed and edited the manuscript; Chao M, Han SG and Jin K were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Jin, MD, Attending Doctor, Department of Radiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. 21118139@zju.edu.cn
Received: June 5, 2020 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
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.
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.
