Presenter: Chinapath Vuthivanich

Affiliation: Vajira Hospital, Bangkok, Thailand

Abstract

This article describes a 55-year-old male with subclavian artery pseudoaneurysm caused by fishbone penetration through the esophagus. Endovascular covered stenting (BeGraft 9×57mm) combined with surgical debridement achieved hemorrhage control and infection resolution.

Introduction

Esophageal foreign body-induced arterial injury requires urgent intervention. This case demonstrates the efficacy of a hybrid approach in life-threatening scenarios.

Case Study

The patient presented with mediastinitis and a pulsatile neck mass.

Key interventions:

Endovascular Therapy: BeGraft stent exclusion of the pseudoaneurysm.

Surgical Management: Neck exploration for fishbone removal and abscess drainage.

Postoperative Care: VATS for residual mediastinal infection.

Follow-up confirmed stent patency and clinical recovery.

Conclusions

1.Covered stents provide immediate hemorrhage control in traumatic fistulas.

2.Multidisciplinary collaboration optimizes outcomes in complex trauma.

3.Early imaging surveillance prevents delayed complications.