Simultaneous false aneurysm and arterio-venous fistula in the presence of a single wound

We describe a patient in whom a stab wound to the right supraclavicular fossa led to a subclavian artery false aneurysm and an arterio-venous fistula (AVF) between the right subclavian artery and the right internal jugular vein. The diagnosis was made clinically and with computerised tomographic angiography (CTA). Open vascular repair was successful. We postulate that this presentation was the result of the knife being inserted then partly withdrawn and reinserted at a different angle. This pattern of injury has been reported previously following central venous line insertion, but rarely following a stab injury.