RadioGraphics 2011; 31:2021-2034
Aya Kamaya, MD , Michael P. Federle, MD , Terry S. Desser, MD
Intraabdominal fat is a metabolically active tissue that may undergo necrosis through a number of mechanisms. Fat necrosis is a common finding at abdominal cross-sectional imaging, and it may cause ab¬dominal pain, mimic findings of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Common processes that are present in fat necrosis include torsion of an epiploic append¬age, infarction of the greater omentum, and fat necrosis related to trauma or pancreatitis. In addition, other pathologic processes that involve fat may be visualized at computed tomography, including fo¬cal lipohypertrophy, pathologic fat paucity (lipodystrophies), and malignancies such as liposarcoma, which may mimic benign causes of fat stranding. Because fat necrosis and malignant processes such as liposarcoma and peritoneal carcinomatosis may mimic one another, knowledge of a patient's clinical history and prior imaging studies is essential for accurate diagnosis.