Korean J Gastroenterol.  2017 Jan;69(1):83-86. 10.4166/kjg.2017.69.1.83.

Pancreatic Panniculitis in Patients with Chronic Pancreatitis: Case Report and Review of Literature

• Kim EJ
• Chu MS
• Sohn KC
• Cho DH
• Na GH
• Kim HC
• Cho EY

• KMID: 2383437
• DOI: http://doi.org/10.4166/kjg.2017.69.1.83

Abstract

Pancreatic panniculitis is a rare complication characterized by subcutaneous fat necrosis associated with pancreatic disease. It has been postulated that pancreatic panniculitis is caused by the systemic activity of pancreatic enzymes that lead to microcirculatory disturbances. We report a 41-year-old heavy alcoholic woman with pancreatic panniculitis that coexisted with acute and chronic pancreatitis. She was diagnosed with chronic pancreatitis and alcoholic liver cirrhosis 5 years ago. She presented with multiple, tender, erythematous, subcutaneous nodules with heat sensation on both lower legs. Laboratory evaluation revealed an increase in the serum blood amylase and lipase. Histopathologic findings showed fat necrosis with inflammation around the necrotic subcutaneous fat tissue. The lesions subsided gradually with an improvement of acute pancreatitis.

Keyword

Panniculitis; Chronic pancreatitis; Subcutaneous fat necrosis

MeSH Terms

Adult
Alcoholics
Amylases
Fat Necrosis
Female
Hot Temperature
Humans
Inflammation
Leg
Lipase
Liver Cirrhosis, Alcoholic
Necrosis
Pancreatic Diseases
Pancreatitis
Pancreatitis, Chronic*
Panniculitis*
Sensation
Subcutaneous Fat
Amylases
Lipase

Figure

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  Fig. 1. Low attenuating lesion with multiple calcifications & peripancreatic fat infiltration (arrows) is seen at head portion of pancreas.

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  Fig. 2. Multiple, ill-defined, erythematous to brownish nodules are shown on both lower legs.

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  Fig. 3. The skin biopsy showing focal areas of adipocytes degeneration surrounded by inflammatory cells infiltration (H&E, ×100).

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