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CT of the abdomen revealed a diffusely enlarged, entirely fatty pancreas with preserved shape and a dilated main pancreatic duct containing intraductal calculi, indicating lipomatous pseudohypertrophy (LPH) with chronic calcific pancreatitis (CCP). Clinical and imaging findings confirmed exocrine insufficiency, while coexisting diabetes mellitus, which can be attributed to CCP, suggested a type 3\u2009c diabetes mellitus. She developed sepsis and despite intensive medical management, she died of refractory septic shock. Enlarged pancreatic volume distinguishes LPH from the usual degenerative fatty replacement commonly seen in older patients or patients with obesity or diabetes.<\/jats:p>","DOI":"10.1136\/bcr-2025-269275","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:45:20Z","timestamp":1790772320000},"page":"e269275","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lipomatous pseudohypertrophy of pancreas with chronic calcific pancreatitis presenting with nutritional dermatosis and type 3c diabetes"],"prefix":"10.1136","volume":"19","author":[{"given":"Sudipta","family":"Mohakud","sequence":"first","affiliation":[{"name":"Radiodiagnosis, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biswanath","family":"Behera","sequence":"additional","affiliation":[{"name":"Dermatology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debananda","family":"Sahoo","sequence":"additional","affiliation":[{"name":"General Medicine, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2026093005450839000_19.9.e269275.1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181bd2923"},{"key":"2026093005450839000_19.9.e269275.2","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1007\/BF01887883","article-title":"Fettsucht und Atrophie der Bauchspeicheldr\u00fcse bei Jugendlichen","volume":"282","author":"Hantelmann","year":"1931","journal-title":"Virchows Arch Path Anat"},{"key":"2026093005450839000_19.9.e269275.3","doi-asserted-by":"crossref","first-page":"S213","DOI":"10.1016\/j.mjafi.2016.08.001","article-title":"Lipomatous pseudohypertrophy of pancreas with coexisting chronic calcific pancreatitis leading to malabsorption due to exocrine pancreatic insufficiency","volume":"72","author":"Nema","year":"2016","journal-title":"Med J Armed Forces India"},{"key":"2026093005450839000_19.9.e269275.4","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.50.579.53"},{"key":"2026093005450839000_19.9.e269275.5","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/j.radcr.2021.03.045","article-title":"A rare case of lipomatous pseudohypertrophy of the pancreas","volume":"16","author":"Luu","year":"2021","journal-title":"Radiol Case Rep"},{"key":"2026093005450839000_19.9.e269275.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5613.293"},{"key":"2026093005450839000_19.9.e269275.7","doi-asserted-by":"crossref","unstructured":"Sivasubramanian D , Prasaanth S , Pancreatogenic MA . 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