Right Subclavian Septic Pseudoaneurysm with Esophageal Fistula due to a Swallowed Fishbone

Abstract

Pseudoaneurysm due to a swallowed fishbone rarely involves subclavian arteries. A 46-year-old male with nonaberrant right subclavian artery (RSA) presented pseudoaneurysm and brachial plexus septic necrosis. Open surgery with sternotomy and right transverse supraclavicular cervicotomy was done in emergency to achieve revascularization using in situ cryopreserved arterial allograft. Infection severity led to septic allograft rupture that necessitated ligation without new arterial reconstruction. During follow-up, patient remained alive 8 months after surgery. Neurological deficit slowly regressed, and no upper arm ischemic sign appeared.