A 25-year-old woman presented to the hospital with a complaint of amenorrhea for 2 years, increased frequency of fatty stools, and decreased appetite for 6 months, generalized body swelling of 2 months duration, fever of 1 month duration, pain abdomen off and on. Physical examination revealed pallor and pitting edema of bilateral lower limbs. Respiratory and cardiovascular system examination revealed no abnormality. No past history of tuberculosis, diabetes mellitus, or hypertension. Ascitic tap revealed clear fluid (transudate). Laboratory investigations revealed decreased total protein, 4.4 g/dL (normal 6-8 g/dL); reduced albumin, 1.9 g/dL (normal 3.5:5 g/dL); and low serum amylase, 8 somogyi units (normal 20-200 somogyi units). Routine blood tests and liver and renal function tests were normal. Chest X-ray revealed left-sided pleural effusion. Ultrasound abdomen revealed hyperreflective pancreas [Figure 1a], free fluid within the pelvic cavity, and mildly dilated small bowel loops with thickened wall. Computed tomography revealed atrophic pancreas with complete fatty infiltration (attenuation value = -120 HU), and no demonstrable normal pancreatic parenchyma [Figure 1b and c]. Solitary calculus was noted within the pancreatic duct near the ampulla of Vater without pancreatic duct dilatation [Figure 1d]. There was no dilatation of intrahepatic biliary radicals or common bile duct. Small bowel wall thickening with increased intraluminal fluid and dilution of contrast medium was also evident [Figure 1e]. On the basis of the above-mentioned findings, the diagnosis of diffuse pancreatic lipomatosis (secondary to chronic pancreatic duct obstruction by calculus) leading to malabsorption, subsequently fatty steatorrhea, hypoproteinemia, and retention of fluid within the body was made.