Fatal pancreatitis presenting with subcutaneous fat necrosis. Evidence that lipase and amylase alone do not induce lipocyte necrosis.

We report a case of fatal pancreatitis heralded by the presence of cutaneous panniculitis without abdominal pain or other stigmata of the disease. Although cutaneous fat necrosis has been associated with pancreatitis, it is unusual as the presenting complaint of this relatively common disease. In vitro evidence suggests that human pancreatic amylase or lipase alone is not responsible for the observed panniculitis.