Fat necrosis is a term that is entrenched in medical practice but does not in reality denote a specific pattern of necrosis. Rather, it refers to focal areas of fat destruction, typically resulting from release of activated pancreatic lipases into the substance of the pancreas and peritoneal cavity. This occurs in acute pancreatitis where pancreatic enzymes leak out of acinar cells and liquefy the membranes of fat cells in the perotoneum. The released lipases split the triglyceride esters contained within fat cells. The fally acids, so derived, combine with calcium to produce grossly visible chalky white areas, which enable the surgeon and the pathologist to identify the lesions.
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