Fat Necrosis

  • Fat Necrosis is a unique morphological pattern of necrosis almost exclusively seen in the context of Acute Pancreatitis or physical trauma to adipose-heavy tissues such as the breast. In the case of Acute Pancreatitis this pattern emerges secondary to inappropriate liberation of pancreatic digestive enzymes which rapidly digest surrounding mesenteric adipose tissue, resulting in unregulated release and digestion of extracellular lipids. Pancreatic lipases digest triglycerides, released from lysed adipocytes, into fatty acids which combine with extracellular calcium, essentially forming soap. This results in the generation of a grossly visible, chalk-like material within the abdomen.