Hemorrhagic pleural effusion and mediastinal mass: presenting symptoms in a child with pseudocyst of the pancreas.

A girl was referred to our hospital because of a right-sided recurrent hemorrhagic pleural effusion associated with a mediastinal mass. It was later found that the findings were due to a pancreatic pseudocyst with internal fistulization through a necrotic opening in the left hemi-diaphragm, and with mediastinal and right-sided pleural extension. The object of this report is to remind clinicians that a pleural effusion and a mediastinal mass may be the presentation of a pseudocyst of the pancreas, and to point out the important of endoscopic retrograde cholangiopancreatography--even for children.