Disseminated subcutaneous fat necrosis and elbow joint arthritis as a complication of pancreatitis

Abstract

Background. Intraabdominal fat necrosis of the retroperitoneum, mesenthery and omentum is a frequent complication of acute pancreatitis. Very rarely, during the disease multiple aseptic subcutaneous fat necrosis, polyarthritis, polyserositis, vasculitis, subcutaneous nodi and eosinophylia, isolated or in combination, may appear. They are known as "pancreatic disease syndrome". Case report. We presented a female patient, 43-year-old, in whom in the course of acute interstitial billiary pancreatitis had occur red multiple localized aseptic necrosis of subcutaneous fat tissue of extremities appeared mostly around the talocrural and wrist joints requiring multiple incision, as well as aseptic elbow joints arthritis requiring puncture of one elbow joint. The symptoms were followed by a prolonged febrility that settled within several weeks. Conclusion. Localized disseminated fat necrosis around joints, arthritis of major joints, alone or with some of other symptoms of the "pancreatic disease syndrome" have to be considered as a probable sign of pancreatitis, even in the abscence of major abdominal symptoms.