J Korean Soc Radiol.  2012 Oct;67(4):249-251. 10.3348/jksr.2012.67.4.249.

Pancreatic Panniculitis Associated with Acute Pancreatitis and Hemorrhagic Pseudocysts: A Case Report

• Jang YS
• Kim MS
• Park CS
• Park JY
• Park NH

• KMID: 1439535
• DOI: http://doi.org/10.3348/jksr.2012.67.4.249

Abstract

Pancreatic panniculitis is an inflammation and necrosis of fat at distant foci in patients with pancreatic disorders, most frequently, pancreatitis and pancreatic carcinoma. Clinically, pancreatic panniculitis is manifested by painless or painful subcutaneous nodules on the legs, buttocks, or trunk. The usual sites are the distal parts of the lower extremities. To the best of our knowledge, there have not been many reports for the radiologic findings of pancreatic panniculitis. In this article, we report a case of pancreatic panniculitis, including radiologic findings of CT and ultrasonography. The patient was presented with painful subcutaneous nodules on the trunk, and had underlying acute pancreatitis and hemorrhagic pseudocysts.

MeSH Terms

Buttocks
Fat Necrosis
Humans
Inflammation
Leg
Lower Extremity
Necrosis
Pancreatic Neoplasms
Pancreatitis
Panniculitis
Pancreatic Neoplasms

Figure

• 

  Fig. 1 32-year-old man with pancreatic panniculitis, associated with acute pancreatitis and hemorrhagic pseudocysts. A. Precontrast axial CT scan shows large cystic mass (arrow) in the pancreatic head with peripancreatic infiltration. Focal area of high attenuation (asterisk) within the cystic mass suggests hemorrhage. Note the small subcutaneous nodule in the anterior abdominal wall (curved arrow). B. Follow up abdomen CT after 3 days. Postcontrast axial CT scan shows multiple, mild enhancing nodules (arrows) with ill-defined margin and perinodular streaky densities in the anterior abdominal wall. Note focal area of low attenuation (arrowhead) indicating cystic portion of nodules. C. Endoscopic retrograde cholangiopancreatography shows the irregular contrast filling of pancreatic pseudocyst (white arrow) communicating with the main pancreatic duct (black arrow). D. Ultrasonography of abdominal subcutaneous nodule. The nodule is mainly cystic with some areas of echogenic solid portions (white arrow). Note the increased vascularity within the solid portion and peripheral wall of nodule (asterisks).

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