What causes Puckered Panniculus Sign in the abdominal wall on imaging?
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Puckered Panniculus Sign is caused by the formation of a central indentation or puckering in the panniculus (subcutaneous fat layer) of the abdominal wall, typically seen on CT or MRI imaging. This sign results from previous abdominal surgery, where postoperative scarring and adhesions lead to focal retraction and indentation of adipose tissue in the surgical area.
Why is it called so?
It is termed “Puckered Panniculus” because the subcutaneous fat (panniculus) exhibits a puckered or wrinkled appearance with a central indentation, resembling the skin puckering seen with scarring and fibrosis post-surgery.
Pathophysiology
Following abdominal surgery, fibrosis and scar contracture develop within the subcutaneous fat. This leads to tethering and localized pulling of the panniculus, which manifests radiologically as a central indentation or puckering of the fat layer.
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