title: An unusual presentation of a fourth pharyngeal arch (branchial cleft) sinus.
abstract: Fourth pharyngeal arch (branchial cleft) sinuses and fistulas are a rare cause of recurrent neck abscesses presenting in the first 2 decades of life. Because they are uncommon, the diagnosis and subsequent treatment can be delayed, even with proper radiographic imaging and clinical evaluation. This case illustrates a life-threatening presentation of a ruptured fourth branchial cleft sinus with extravasation into the mediastinum, chest, and abdomen.
authors.affiliation: Department of Pediatric Surgery, Wake Forest University Baptist Medical Center, NC, USA.
authors.forename: Lucas
authors.initials: L
authors.lastname: Neff
authors.forename: Daniel
authors.initials: D
authors.lastname: Kirse
authors.forename: Thomas
authors.initials: T
authors.lastname: Pranikoff
mesh_terms: D000293:Adolescent; D001934:Branchial Region / Q000002:abnormalities* / Q000601:surgery; D004564:Electrocoagulation; D016724:Empyema, Pleural / Q000209:etiology*; D006801:Humans; D006872:Hydropneumothorax / Q000209:etiology; D007828:Laryngoscopy; D008297:Male; D008480:Mediastinitis / Q000209:etiology*; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed