Diffuse pericardial, intraabdominal, and subcutaneous non-infected fat necrosis in patient with chronic pancreatitis, managed with thoracoscopic and abdominal debridement

We describe a patient that acutely presented with concomitant non-infected diffuse pericardial, intraabdominal, and subcutaneous fat necrosis in the setting of previously undiagnosed chronic calcific pancreatitis. There was no associated pancreatic necrosis, pseudocyst, or fistula. We have not encountered in the literature a previous description. The patient was managed with combination of abdominal and thoracoscopic resections and a favorable 4-year outcome. Exact mechanism of this case is uncertain. Based on clinical, intraoperative, and imaging findings, we consider that the etiology was intraabdominal and most likely related to chronic pancreatitis in the setting of metabolic syndrome.