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Pancreatic panniculitis following endoscopic retrograde cholangiopancreatography (ERCP): a case report

Year: 2025

Type: article

Abstract: Pancreatic panniculitis following endoscopic retrograde cholangiopancreatography (ERCP): a case report ଝ Dear Editor, Pancreatic panniculitis is a rare cutaneous manifestation that occurs in 0.3%---3% of patients with pancreatic disease.It is postulated that damage to the pancreas causes hematogenous release of digestive enzymes, which increases the permeability of the microcirculation within the lymphatic vessels and leads to fat saponification with necrosis of the subcutaneous tissue.The most common underlying etiology is acute pancreatitis (88% of cases), while pancreatic neoplasms account for approximately 12%.1---4 This case report describes a case of pancreatic panniculitis that occurred after a cholangiography examination.A 76-year-old caucasian woman with hypertension was admitted to a referral hospital for gastroenterology care due to abdominal pain, loss of appetite, nausea, vomiting, and jaundice for three days.Laboratory tests on admission showed anemia (hemoglobin 10.2 g/dL), leukocytosis with neutrophilia (11,930 mm 3 ), eosinophilia (450 mm 3 ), elevated transaminases (AST 85 /L [normal 14---36 /L], ALT 331 /L [normal < 35 /L]), alkaline phosphatase (180 /L, normal 36---126 /L), gamma-GT (285 /L, normal 12---43 /L), total bilirubin (7.10 mg/dL, normal 0.2---1.3mg/dL), and direct bilirubin (3.5 mg/dL, normal 0---0.3mg/dL), with no change in amylase or lipase.An abdominal CT scan was performed, which identified dilation of the intra-and extrahepatic bile ducts, with obstruction in the distal portion of the common bile duct at the level of the duodenal papilla.Subsequently, endoscopic retrograde cholangiopancreatography (ERCP) was performed, combined with sphincterotomy and insertion of a plastic biliary stent.Since no stones were identified in the common bile duct, papillitis, pancreatic head tumor, or dis-

Source: Anais Brasileiros de Dermatologia

DOI: 10.1016/j.abd.2025.501211

Authors: Rebecca Perez de Amorim, Laís Maria Bellaver de Almeida, Hélio Amante Miot, Juliano Vilaverde Schmitt

Institution: Universidade Estadual Paulista (Unesp)

Language: English

Topic: Pancreatitis Pathology and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,700