Abstract
A 43-year-old man underwent subtotal pancreatectomy for chronic pancreatitis with subcutaneous and bone marrow fat necrosis. Postoperatively symptoms of chronic pancreatitis and subcutaneous necrosis resolved, but bone marrow fat necrosis became worse. The patient died of multiple organ failure 3 years and 5 months after the operation.Chiari first reported an association between subcutaneous fat necrosis and pancreatic disease in 1883 and subsequently several additional cases were reported in Europe and the United States of America. In Japan, few cases of fat necrosis have been reported, and this case is only the 11th. Seven cases were associated with acute or chronic pancreatitis and three cases were postoperative complications. If the release of pancreatic enzymes into the general circulation secondary to pancreatic inflammation is the primary etiologic factor in fat necrosis, then treatment by subtotal pancreatectomy is a reasonable approach. This case supports this hypothesis, at least in cases of subcutaneous fat necrosis.
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