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Pancreatic Steatosis

An Emerging Clinical Entity

Ramkissoon, Resham MD1; Gardner, Timothy B. MD, MS1

American Journal of Gastroenterology: November 2019 - Volume 114 - Issue 11 - p 1726–1734
doi: 10.14309/ajg.0000000000000262

Pancreatic steatosis is an emerging clinical entity whose pathophysiology, natural history, and long-term complications are poorly characterized in the current literature. Epidemiological and prospective studies have described prevalence rates between 16% and 35%. Although the natural history is not well known, there are strong associations with obesity, metabolic syndrome, type 2 diabetes mellitus, and nonalcoholic fatty liver disease. Ectopic fat accumulation of the pancreas can cause chronic, low-grade inflammation from adipocytokine imbalances that involve beta cells and acinar cells. This mechanism can lead to pancreatic endocrine and exocrine dysfunction and initiate carcinogenesis. Although it is associated with morbid conditions, pancreatic steatosis may be amendable to treatment with a healthy diet, less meat consumption, exercise, and smoking cessation. Pancreatic steatosis should factor into clinical decision-making and prognostication of patients with pancreatic and systemic disease. This review seeks to describe the pathophysiology, natural history, diagnosis, and complications of this emerging clinically relevant entity.

1Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

Correspondence: Resham Ramkissoon, MD. E-mail:

Received October 01, 2018

Accepted March 12, 2019

Online date: May 23, 2019

© The American College of Gastroenterology 2019. All Rights Reserved.
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