Esophageal perforation with mediastinitis leading to mycotic aortic pseudoaneurysm in a pediatric patient: A complication of sharp foreign body ingestion.

Esophageal perforation resulting from foreign body ingestion is a known complication that can lead to various complications, including esophageal erosion, esophageal perforation, and mediastinitis, with rare involvement of adjacent anatomical structures. Uncommonly, it can also result in the formation of a mycotic aortic pseudoaneurysm. In this report, we describe a 9-month-old girl who presented with an esophageal perforation following ingestion of a pin. She developed life-threatening mediastinitis with a mycotic aortic pseudoaneurysm in the aortic arch that required urgent surgical repair, which involved evacuation of infected mediastinal hematoma, resection of the mycotic aortic pseudoaneurysm, and reconstruction of the aortic arch. The patient did well after surgery and was discharged home in satisfactory condition. The case highlights the importance of early diagnosis, prompt intervention, and antibiotic therapy in esophageal perforation with suspected mediastinitis. Awareness of this life-threatening complication is crucial for optimizing patient outcomes.