Internal pancreatic fistula in a child with pancreas divisum: An unusual manifestation of an uncommon anomaly.
OBJECTIVE
Report of an unusual case of pancreatic fistula in a child.


BACKGROUND
Pancreatic diseases are relatively uncommon in the pediatric age group, with a rather heterogeneous clinical picture from generic abdominal distension to massive pleural effusion.


CONCLUSIONS
The amylase analysis of pleural liquid is crucial for the etiologic diagnosis of pancreatitis with internal pancreatic fistula. Magnetic resonance cholangiopancreatography may support the etiologic diagnosis of pancreatic pleural fistula in children. Management of internal pancreatic fistula is analyzed.


CONCLUSIONS
Maintaining a high index of suspicion is essential for the etiologic diagnosis of pancreatic pleural fistula in children.
Nacoti
Mirco
M
Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Ospedali Riuniti, Bergamo, Italy.
Riva
Luca
L
Vedovati
Sergio
S
Bolis
Alessandra
A
Agazzi
Roberto
R
Fumagalli
Roberto
R
D000681:Amylases / Q000032:analysis; D049448:Cholangiopancreatography, Magnetic Resonance; D004322:Drainage; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D010179:Pancreas / Q000002:abnormalities*; D010185:Pancreatic Fistula / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010195:Pancreatitis / Q000150:complications; D010289:Parenteral Nutrition, Total; D010996:Pleural Effusion / Q000201:enzymology / Q000209:etiology
D005765:Gastrointestinal Agents; D000681:Amylases; D015282:Octreotide