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

Objectives: 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. Clinical Relevance: 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. Conclusion: Maintaining a high index of suspicion is essential for the etiologic diagnosis of pancreatic pleural fistula in children.