Internal jugular phlebectasia - an unusual cause of neck swelling

We describe a 7-year-old child who presented with a soft fluctuant swelling on the neck which became more prominent during the Valsalva manoeuvre. He underwent adeno-tonsillectomy based on a mistaken diagnosis of ballooning o f the pharynx secondary to enlarged adenoids and tonsils obstructing the na sopharyngeal and oropharyngeal airways. Investigations revealed the swellin g to be a markedly dilated internal jugular vein. We discuss the diagnostic features and mode of treatment of this condition so as to avoid unnecessar y and dangerous surgical intervention.