Abstract

Branchial arch anomalies can arise from the four first branchial arches, but the most encountered cases are from the second one. Second branchial arch cysts and abscesses occur mainly in older children or young adults while fistulae are discovered in young children. We report a case of complete second branchial arch fistula of Bailey III type with adult complaints of painful swelling and local reddishness followed by spontaneous discharge and disappearance of complaints. Diagnosis was based on ultrasound and confirmed by CT scan, with the classic “beak sign” visible on both exams. Three cases were encountered in the family, with no otologic or kidney symptoms, which is quite different from the classical branchiootorenal syndrome which associates severe inner ear and kidney congenital anomalies.

Highlights

  • Congenital anomalies are often encountered in the pediatric population and always stay on top of the gamut of differential diagnoses

  • We report a case of complete second branchial arch fistula of Bailey III type with adult complaints of painful swelling and local reddishness followed by spontaneous discharge and disappearance of complaints

  • We present here a case of a 60-year-old lady presenting at the emergency department with symptoms caused by an inflamed and temporarily obstructed second branchial arc fistula

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Summary

Introduction

Congenital anomalies are often encountered in the pediatric population and always stay on top of the gamut of differential diagnoses. Some congenital anomalies may be sparsely symptomatic during childhood and have late more explosive symptoms. In the case of second branchial arch anomalies, fistulae, cysts and abscesses can be encountered: fistulae in young children, cysts and abscesses in older children and young adults. We present here a case of a 60-year-old lady presenting at the emergency department with symptoms caused by an inflamed and temporarily obstructed second branchial arc fistula. A discussion follows about the genetic transmission of this pathology in the family

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