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Congenital pyriform sinus fistula presenting as a neck abscess in a newborn: A case report
Yishu Teng1, Shuling Huang, Guowei Chen
1Department of Otolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Rationale:
Congenital pyriform sinus fistula (CPSF) is a branchial abnormality originating from the third or fourth branchial pouch and is an important cause of anterior cervical abscess in children. Here we present a case of neck abscess in a newborn that was diagnosed as CPSF.
Patient Concerns:
A male infant with a birth weight of 3660 g was admitted to hospital 25 minutes after birth after discovery of a cystic mass with extensive skin swelling in the left side of the neck. B-mode ultrasonography of the left neck showed an anterior cervical cystic mass of indeterminate nature.
Diagnosis:
Congenital pyriform sinus fistula.
Interventions:
The neck abscess was incised and drained under general anesthesia. Examination under suspension laryngoscopy revealed a pyriform sinus fistula. Laser cauterization was performed simultaneously. The wound was dressed and anti-inflammatory treatment was provided.
Outcomes:
The neck wound healed uneventfully. After 3 months, the fistula was confirmed to be closed by laryngoscopy under general anesthesia. No recurrence was detected during 9 months of follow-up.
Lessons:
CPSF should be strongly suspected in a patient with an unexplained neck abscess or recurrent acute suppurative thyroiditis, especially on the left side.
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