Recurring neck infection leads to three surgeries before doctors diagnose rare congenital condition in 7-year-old

For 7-year-old Ritam Sarkar from West Bengal, childhood was marked not by play alone, but by repeated pain, swelling, and hospital visits. What appeared to be a routine neck infection kept returning despite multiple surgeries. The relief was only temporary each time this occurred. The original condition continued to re-occur again and thus confused and frustrated the family involved. Over the years, the child underwent three surgical procedures at local hospitals. However, none had provided him with a lasting solution since the source of the problem had never been identified.

Upon Ritam’s referral to Manipal Hospital Varthur for thorough evaluation, Dr. Debasish Datta Majumder, Consultant – ENT performed sophisticated imaging studies. Through this process, Dr. Debasish diagnosed Ritam with a rare congenital disorder called a fourth branchial cleft cyst abnormality. “This condition develops before birth, when parts of the neck that should normally fuse fail to do so,” explained Dr. Debasish. “As a result, an abnormal tract remains, extending from the skin of the neck deep toward the throat. Since fourth branchial cleft anomalies account for only 1–4% of all branchial anomalies, they are often missed, making diagnosis especially challenging.”

Once the diagnosis was confirmed through radiological investigations, Ritam underwent a definitive surgical procedure, which involved meticulously tracing and removing the entire abnormal tract, right up to its origin near the throat. The operation lasted about one and a half hours and the results were immediate and reassuring. Ritam was discharged the next day and managed to recover smoothly. No recurrence of swelling or infection was noticed.

Ritam appeared much more upbeat in the follow-up session since he had now been released from the issue that had hindered the nature of his life for many years. Ritam’s story demonstrates how critical it is for parents and caregivers to understand that repeated infections; cysts or lumps, located in the same place, should not be ignored as it can be a rare congenital disease that mimics a simple abscess.

Early recognition can spare children from unnecessary procedures, prolonged suffering, and emotional distress.