A complete second branchial fistula in a four years old child

Introduction and importance: Second branchial anomalies either cyst, sinus, or fistula are the top differential diagnosis of lateral neck masses or swelling in pediatrics age group. Yet, it is very rare for the branchial fistula to have two openings.Case presentation: Here we present a four years old child diagnosed with complete branchial fistula by CT scan with dye injection throughout the fistula tract. We successfully managed him by complete surgical resection. Also, we provide the current literature that aids in the diagnosis and treatment of complete second branchial fistula.Conclusion: Complete second branchial fistula is not that common anomaly; however, we must consider it as a differential diagnosis in any lateral neck masses. Complete surgical resection, step ladder approach, which will minimise the recurrence rate is the treatment of choice.