Added Value of Cross-SectionalImaging in Total Pancreatic Lipomatosis: An Institutional Experience from Northeast India

Abstract

Background:

Total fatty replacement of the pancreas results in exocrine pancreatic enzyme deficiency, which may lead to malabsorption. This study aimedto evaluate the added value of multi-detector computed tomography (MDCT) and magnetic resonance imaging (MRI) intotal pancreatic lipomatosis (TPL).

Materials and Methods:

This retrospective study covered 19 consecutive patients of TPL in a tertiary care hospital from November 2019 to June 2021 with a review of clinical and cross-sectional imaging data. MDCT was done in 10 patients, and an MRI scan in 9 patients. Pancreatic volume was measured and correlated with the patient body habitus.

Results:

19 patients (male=9, female=10) had TPL with a mean age of 39.37±14.09[SD] years.Total pancreatic parenchymal atrophy was observed in 10 patients (52.6%), followed by near-total atrophy in nine patients (47.2%). The main pancreatic duct (MPD) was gross diffuse irregularly dilated in seven patients (36.8%) and mild diffuse irregularly dilated in 11 patients (57.9%). Sixpatients (31.6 %) of TPL wereassociated with malabsorption syndrome. The mean volume of the lipomatous pancreas was 150.1±72.7 [SD] cm3. The lipomatous pancreatic volume significantly correlated with the patient’s body habitus with a P value of 0.05 using an independent sample ttest.

Conclusion:

MDCT and MRI play an important role in diagnosing the degree of pancreatic lipomatosis, and they can find out the possible underlying cause of TPL and even chronic sequelae of TPL, such as malabsorption syndrome.