Extra Pancreatic Fat Saponification in the Background of Acute Pancreatitis Mimicking Carcinomatosis

Abstract

Acute pancreatitis is frequently associated with retroperitoneal fat necrosis, most often localized to the peripancreatic region. In certain cases, this process may extend into the transverse mesocolon, omentum, and mesenteric root, leading to diffuse extra-pancreatic fat saponification. Although retroperitoneal fat necrosis is readily identified on contrast-enhanced computed tomography (CECT), the characteristic features of fat saponification are often subtle and not prominently visualized on imaging." We report a case of acute pancreatitis complicated by extensive fat saponification involving both the retro peritoneum and peritoneal surfaces, which closely simulated peritoneal carcinomatosis on CT imaging. Given that such findings are infrequently demonstrated radiologically, this entity should be considered among the differential diagnoses when evaluating abdominal fat-related abnormalities on imaging studies.