Abstract
Acute pancreatitis, the most common pancreatic disease in children (1-13 cases per 100,000 children per year), uncommonly presents with extrapancreatic fat necrosis and saponification. This uncommon manifestation can radiologically and intraoperatively resemble peritoneal carcinomatosis or neoplasms, often necessitating histopathological confirmation. Integrating clinical and radiological findings is crucial for accurate diagnosis and to avoid unnecessary interventions. We present a case of an adolescent with acute pancreatitis and extrapancreatic fat saponification mimicking carcinomatosis (with histopathological confirmation), highlighting key imaging features.