Osteomyelitis: A rare complication of pancreatitis and PPP-syndrome

Joint Bone Spine. 2016 Mar;83(2):221-4. doi: 10.1016/j.jbspin.2015.05.005. Epub 2015 Oct 23.

Abstract

Pancreatic diseases can be accompanied by periarthritis with bone necrosis and panniculitis (PPP-syndrome). It is postulated that this is caused by systemic activity of pancreatic enzymes leading to microcirculatory disturbances and fat necrosis. The morbidity and mortality of the PPP-syndrome is high. Successful treatment of pancreatitis can lead to resolution of accompanying panniculitis and periarthritis without adverse sequelae, but weeks or months after pancreatitis, asymptomatic necrosis of the bone may become symptomatic by fracturing spontaneously. In this report, we also describe osteomyelitis as a severe septic complication of bone necrosis caused by pancreatitis, in one case as acute tissue necrosis and in another case months after pancreatitis spread haematogenously.

Keywords: Osteomyelitis; Osteonecrosis; PPP-syndrome; Pancreatitis; Panniculitis.

Publication types

  • Case Reports

MeSH terms

  • Arthritis / complications
  • Arthritis / pathology
  • Bone Diseases / complications*
  • Bone Diseases / pathology
  • Bone and Bones / pathology
  • Humans
  • Male
  • Middle Aged
  • Necrosis
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / etiology*
  • Osteomyelitis / therapy
  • Pancreatitis / complications*
  • Panniculitis / complications*
  • Syndrome