Pathology of Fat stranding

[bioguy]

I had an autopsy case of duodenal perforation and pancreatitis today. CT scan showed "fat stranding" around the bowel. Grossly all the peritoneal fat appeared chalky, friable and wierd, with lots of adhesions. Has anyone seen such a case? Is there a sophisticated way to describe it grossly?

I am trying to word the PAD. Any help is appreciated.

Strangely I could not find any pathological description of fat stranding in textbooks/internet. Fat stranding is a radiological term to describe the fat seen in cases of peritonitis and pancreatitis.

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[yaah]

I think that is because the fat is becoming damaged and necrotic, calcified, etc. So it becomes a different consistency as seen by the radiographic machine. This damage often travels linearly, thus the stranding. It is probably just best described as peritonitis and pancreatitis with adhesions and fat necrosis.

 

[Gene_]

Just describe what you see without making specific diagnoses. I once had a case that I expected to be raging peritonitis, but it turned out to be something entirely different after looking at the slides.

 

[multiplemyeloma]

isn't that what is known as 'saponification'?

 

[Gene_]

isn't that what is known as 'saponification'?

it sure sounds like it. i guess "the peripancreatic fat is blah blah blah c/w saponification" would work for the PAD.

 

[TMZ2007]

A surgery attending in med school described fat stranding as edematous mesentery, often seen in the context of pancreatitis or diverticulitis.

I've had a few cases of raging pancreatitis at autopsy; calcified mesentery is best described as "saponification", as stated above.