Clinical features and outcomes of total pancreatic lipomatosis with chronic pancreatitis: a case series

Abstract

Background Fatty changes in the pancreas are common, whereas total pancreatic lipomatosis (PL) is rare. Commonly associated with various components of metabolic syndrome and metabolicassociated steatotic liver disease, total PL can have various etiologies and can manifest with severe pancreatic exocrine insufficiency.

Method We retrospectively analysed the clinical profile and management outcomes of 8 patients (mean age: 37.1 years; 5 male) with total PL seen at a tertiary care center over the last 15 years.

Results All patients presented with abdominal pain and had coexistent chronic pancreatitis, while 5/8 (62%) patients had metabolic syndrome. None of the patients had a history of acute pancreatitis or congenital syndromes, nor developed pancreatic carcinoma in the follow up. Seven (87%) patients had pancreatic ductal dilatation and calcification. All patients had pancreatic exocrine insufficiency, while 5/8 (52%) patients had endocrine insufficiency. Six (75%) patients were successfully managed with pancreatic endotherapy.

Conclusions Pancreatic endotherapy is safe and effective in the treatment of abdominal pain in patients who have chronic pancreatitis with total PL. These patients have a high frequency of pancreatic exocrine as well as endocrine insufficiency.

Keywords Chronic pancreatitis, fatty pancreas, endosonography, diabetes

Ann Gastroenterol 2025; 38 (1): 100-104