Abstract
Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare manifestation (prevalence 2%-3%) of underlying pancreatic pathology which is characterized by fat necrosis in subcutaneous tissue and joints. The widely accepted etiological hypothesis is systemic dissemination of pancreatic lipase. It has a mortality rate approaching 25%. We present a case of pancreatitis, panniculitis, and polyarthritis syndrome in a 52-year-old man with chronic pancreatitis complicated by pancreatico-pericardial fistula.