case_images: PMC5066581_01
case_images: A 3-year-old patient. Fistulous orifice and erythematous halo located in the anterior border of the left sternocleidomastoid muscle.
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case_images: MRI reveals the presence of pyriform sinus fistula and the extension of abscess toward pyriform fossa.
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case_images: After 8 months, an MRI revealed an expansive lesion of 2.5 cm (Figure 2) located medially to the left sternocleidomastoid muscle, with offshoots to the left antero-lateral wall of the hypopharynx.
case_images: Pyriform sinus fistula demonstrated by contrast swallow study.
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case_images: Further clinical controls revealed the reappearance of the fistulous orifice and leakage of liquid food material and saliva during swallowing as confirmed by barium swallow test (Figure 3).
case_images: (a) Endoscopical identification of the internal orifice of the fistula (little arrow) and the entrance of the esophagus (blue arrow) (b) Insertion of the probe into the fistula.
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case_images: After endoscopical identification of the internal orifice (Figure 4(a)), the fistula was catheterized (Figure 4(b)) and injected with 1 mL of Glubran 2 (Gem s.r.l.
case_images: Barium swallow test after endoscopic chemo-cauterization demonstrates the absence of leakage.
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case_images: At discharge, fistulous drainage had ceased and radiologic examination showed the absence of leakage (Figure 5).
case_images: Disappearance of fistulous orifice and detail of cutaneous scar after 6 years of follow-up.
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case_images: The clinical and radiological 6-year follow-up confirmed the absence of the fistulous orifice and the persistence of scar due to previous open-neck surgical procedures (Figure 6).