Giant paediatric common carotid pseudoaneurysm after fish bone ingestion treated with primary end-to-end repair

Area of Science:

• Vascular Surgery
• Pediatric Surgery
• Diagnostic Imaging

Background:

• Foreign body ingestion, particularly fish bones, can lead to delayed complications in children.
• Vascular injuries, such as pseudoaneurysms, are rare but serious sequelae of foreign body ingestion in the neck.
• Delayed presentation of neck masses in pediatric patients warrants thorough investigation for underlying vascular pathology.

Purpose of the Study:

• To report a rare case of a giant carotid artery pseudoaneurysm in a child secondary to fish bone ingestion.
• To highlight the diagnostic challenges and management of delayed vascular complications after foreign body ingestion.
• To evaluate the efficacy and safety of primary end-to-end arterial anastomosis for pseudoaneurysm repair in a pediatric patient.

Main Methods:

• A 7-year-old boy with a history of fish bone ingestion presented with a neck mass.
• Contrast-enhanced CT angiography was performed to diagnose the pseudoaneurysm of the right common carotid artery.
• Surgical management involved complete pseudoaneurysm excision and primary end-to-end arterial anastomosis.

Main Results:

• A 5 × 5 cm pseudoaneurysm of the right common carotid artery was identified.
• The patient underwent successful surgical repair with primary end-to-end arterial anastomosis.
• Postoperative recovery was uneventful, with no neurological deficits, and the anastomosis remained patent at two-year follow-up.

Conclusions:

• Vascular injury should be considered in pediatric patients presenting with delayed neck masses after foreign body ingestion.
• Primary end-to-end arterial anastomosis is a viable and safe surgical option for managing carotid artery pseudoaneurysms in selected children.
• Early diagnosis and appropriate surgical intervention are crucial for favorable outcomes in pediatric vascular trauma.