Pseudoaneurysm of the Common Carotid Artery in an Infant due to Swallowed Fish Bone

Abstract

Carotid artery pseudoaneurysm is a rare condition, particularly in the paediatric population. Only about 30 cases of carotid artery aneurysms in infants have been published until now. This paper reports the case of a giant pseudoaneurysm of the left common carotid artery due to swallowed fish bone by an 8-year-old boy. This pseudoaneurysm was 5.5 cm transverse-diameter and resulted in severe respiratory distress. It was treated by resection and end-to-end anastomosis with satisfactory outcome after one-year follow-up. To the best of our knowledge, this is the largest carotid artery pseudoaneurysm ever described in children.

Percutaneous ultrasound guided thrombin injection for axillary artery pseudoaneurysm following stenting of the arterial duct in two infants: Case report with review of literature

“…Failure rates are higher in ultrasound guided pseudoaneursym sac neck compression . Thrombin injection and surgical resection with end to end anastomosis or bypass graft have also been reported. However thrombin injection is less invasive compared to surgery especially in infants.…”

“…18,19 Failure rates are higher in ultrasound guided pseudoaneursym sac neck compression. 6,7,10 Thrombin injection 7,10 and surgical resection with end to end anastomosis 6,8,9,13,20 or bypass graft 11 have also been reported.…”

A child in shock: carotid blowout syndrome

“…Although doppler US can confirm a mass to be of vascular origin and allow blood-flow assessment,35 CTA is the preferred modality since it provides information about the structure and status of surrounding vessels (including intracranial circulation) 29. MRI and MR angiography may add value by helping to visualise both the pseudoaneurysm and the surrounding tissue and also evaluate the distal organ (ie, the brain) 4. Digital subtraction catheter angiography will define the anatomy of the pseudoaneurysm and importantly assess for collateral circulation23 30 and can be combined with endovascular treatment, as in our case.…”

“…They are usually benign in nature, and may be congenital or of infectious origin—commonly, reactive lymphadenopathy, lymphadenitis or mycobacterial infections. Rarely, they may be due to vascular abnormalities or malignancy 1–5…”

“…Children with carotid artery pseudoaneurysms can present with a range of complaints, including a pulsatile neck mass30 or thromboembolic episodes 24. A cervical mass can compress the upper airways leading to dyspnoea31 32 or nerves leading to focal palsies,29 dysphagia or Horner’s syndrome 4…”