1) To provide a unique look at a patient's congenital right subclavian arteries 2) Discuss the different types of congenital aberrant right subclavian arteries

Penetrating neck injuries comprise around 10% of all trauma injuries with 50% of deaths due to vascular injuries [1]. Commonly, rapid clinical deterioration occurs due to haemorrhagic, obstructive, or mixed major vessel damage, often complicated by airway and intrathoracic involvement. This case report is unique in that it provides clear imaging of a rare congenital aberrant right subclavian artery (RSA) that saved this patient’s life, which itself carries a known incidence of around 0.5-2.5% [2].

We present a 40-year-old patient A.B., presenting to a tertiary Emergency Department with a large tree branch impaled in their right neck. Fortunately, A.B. remained hemodynamically stable, spoke in full sentences, with no active bleeding or pulsatile neck hematoma appreciated. Neurological assessment was grossly unremarkable. Considering the patient’s clinical stability, maintaining their own airway, or concerns for a massive haemorrhage, a computed tomography (CT) angiography was performed to best plan the surgical approach and assess the degree of injury. The CT Head and Neck angiogram...

Penetrating neck injuries with retained foreign bodies carries significant morbidity and mortality. Here, the patient’s rare RSA aberrancy saved their life, despite a profound neck injury that would otherwise be fatal. Ultimately, sheer luck and early radiological intervention helped delineate the extent of the patient’s injury, facilitating a successful patient outcome.

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