A Neonate With Pyriform Sinus Fistula Developing a Large Cervical Cyst Diagnosed by Prenatal Ultrasound

Abstract

A male neonate was born by emergency caesarean section because of chorioamnionitis at 39 weeks of gestation. A cystic lesion was found in the left thoracic cavity by fetal ultrasound at 33 weeks of gestation. MRI showed a cystic mass of 66 × 26 × 24 mm size from the left cervix to the anterior mediastinum after birth, and a nasogastric tube was placed to prevent infection and cyst enlargement. Esophagography revealed contrast agent flow into the tract on the pyriform sinus. We diagnosed the patient as having left pyriform sinus fistula and performed pyriform fistro-cystectomy at the age of 36 days. He was discharged 19 days after the operation without sequela except for transient hoarseness. The hoarseness spontaneously resolved about 1 month after the surgery. In this case of a giant pyriform sinus fistula, infection was prevented by tube feeding and the fistula was successfully removed by elective surgery.