Panniculitis associated with a pancreas divisum.

A case is presented of a 67-year-old man with chronic abdominal pain thought to be due to peptic ulcer disease. He developed nodules of panniculitis (nodular fat necrosis), resulting in extensive investigations for pancreatic disease. He was ultimately found to have low-grade pancreatitis associated with a pancreas divisum. Surgical treatment of this congenital anomaly resulted in complete resolution of the panniculitis and abdominal pain. Panniculitis as a manifestation of pancreatitis is well documented. However, panniculitis leading to the discovery of chronic pancreatitis with a surgically treatable ductal abnormality has not been previously reported. In cases of unexplained nodular fat necrosis, an aggressive search for a pathologic condition of the pancreas is indicated.