2016 Volume 52 Issue 6 Pages 1246-1250
The frequency of recurrence after surgery for pyriform sinus fistula is high (15–25%). Although surgery is the standard treatment for recurrent pyriform sinus fistula, it is difficult to identify fistulas located in scar tissues after abscess formation. We report a case of recurrent pyriform sinus fistula, in which the fistula was identified and ligated using endoscopy, fluoroscopy, and contrast radiography. A 5-year-old boy, who underwent surgery for a pyriform sinus fistula at the age of three, was referred to our hospital because the anterior region of the left side of his neck was swollen. Esophagography revealed a fistula that was in contact with the left pyriform sinus, which led to the diagnosis of a recurrent pyriform sinus fistula. During the reoperation, by grasping a guidewire that was inserted into the internal orifice of the fistula under endoscopy and fluoroscopy, the fistula was identified and dissected. The fistula was successfully ligated under endoscopy. The use of endoscopy, fluoroscopy, and contrast radiography during surgery aids in the identification and ligation of pyriform sinus fistulas hidden within scar tissues both in the initial operation and reoperation.
