Improved management of pancreatic lesions in children aided by ERCP.

Internal pancreatic fistulas have only recently been recognized as distinct entities in children. Unless their pathophysiology is understood they can present the clinician with a diagnostic dilemma. Recently, these entities have been better defined in the adult literature and significant improvement made in treatment. We report a case of a child with pancreatic ascites in whom endoscopic retrograde cholangiopancreatography significantly aided the diagnosis and the operative management. An outline of recommended management of pancreatic lesions in children is presented including internal pancreatic fistulas.