Complex branchial fistula: A variant arch anomaly

A 5-year-old boy presented with an infected left-sided branchial fistula. D espite antibiotic treatment and repeated excision of the fistula, purulent discharge from the wound persisted. Th ree-dimensional computed tomography (3D CT) reconstruction greatly facilitated the diagnosis and management of this case by showing the course of the fistulous tract. The complexity of t he tract suggests that this represents variant arch anomaly because it cont ains features of first, second, third, and fourth arch remnants. Copyright (C) 2001 by W.B. Saunders Company.