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

A 7-year-old boy with a history of fish bone ingestion presented with a progressively enlarging, painless right-sided neck mass one year after the initial event. Contrast-enhanced CT angiography revealed a giant 5 × 5 cm pseudoaneurysm originating from the right common carotid artery. Surgical treatment consisted of complete excision of the pseudoaneurysm followed by primary end-to-end arterial anastomosis. The patient was extubated on postoperative day one and discharged on day five without neurological deficits. At two-year follow-up, Doppler ultrasonography demonstrated durable patency of the anastomosis with no evidence of recurrence or stenosis. An intraoperative surgical video demonstrating aneurysm excision and primary end-to-end repair is provided as supplementary material. This case highlights the importance of considering vascular injury in children presenting with delayed neck masses after foreign body ingestion and supports primary end-to-end repair as a safe surgical option in selected paediatric patients.