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Jang, Kim, Park, Park, and Park: Pancreatic Panniculitis Associated with Acute Pancreatitis and Hemorrhagic Pseudocysts: A Case Report
Abdominal Radiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2012; 67(4): 249-251.

Published online: 8 October 2012

DOI: https://doi.org/10.0000/jksr.2012.67.4.249

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

Yong-Suk Jang, MD, Mi Sung Kim, MD, Chan-Sub Park, MD, Ji-Yeon Park, MD, Noh Hyuck Park, MD

Department of Diagnostic Radiology, College of Medicine, Kwandong University, Myongji Hospital, Goyang, Korea.

Corresponding author: Mi Sung Kim, MD. Department of Diagnostic Radiology, College of Medicine, Kwandong University, Myongji Hospital, 697-24 Hwajeong-dong, Deogyang-gu, Goyang 412-270, Korea. Tel. 82-31-810-7164, Fax. 82-31-810-6537, misung@kwandong.ac.kr

Received 13 April 2012       Accepted 26 July 2012

Copyright © 2012 The Korean Society of Radiology

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.

Keywords: Fat Necrosis, Pancreatitis, Panniculitis, Pseudocyst

Figures and Tables

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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