Chronic pancreatitis with multiple pseudocysts and pancreatic panniculitis

RATIONALE: Pancreatic pseudocyst can present single or multiple, inside or outside the pancreas. Pancreatic panniculitis is a rare skin lesion in pancreatic disease patients. The purpose of this study is to report a case of chronic pancreatitis coexisting with multiple pseudocysts and pancreatic panniculitis. PATIENT CONCERNS: A 46-year-old man with chronic pancreatitis presented multiple small cystic lesions inside the head of the pancreas and two large cystic lesions adjacent to the tail of the pancreas. The patient also developed subcutaneous nodules involving upper and lower limbs, hands, and lower abdomen bilaterally. DIAGNOSIS: The patient was diagnosed with pancreatic pseudocyst and pancreatic panniculitis resulted from chronic pancreatitis. INTERVENTIONS: Bile duct stent and pancreatic duct stent placement was performed endoscopicly. OUTCOMES: Panniculitis faded three weeks later and the pancreatic pseudocysts disappeared six weeks later. LESSONS: Clinicians should be aware of the manifestation of multiple pancreatic pseudocyst and pancreatic panniculitis, and endoscopic transpapillary drainage may be a effective way in this scenario.