DOI: http://dx.doi.org/10.18203/2349-2902.isj20212293

A case report of complete pancreatic lipomatosis

Nuvvula Satwik, Sanjay Nagappa Koppad, Srikar Rao Nadipally

Abstract


The pancreas is an exocrine and endocrine organ that is related to the stomach, duodenum, colon and spleen. Fatty degeneration of the pancreas is common with aging. The entire pancreas may be replaced by fat and the patient may have no clinical symptoms. We here presented a case of a 28 years old male known case of type 2 diabetes diagnosed 3 months back, who was admitted to our hospital for diffuse abdominal pain for the past 2 months, which was non-colicky in nature associated with nausea, anorexia, diarrhea and generalized weakness, no aggravating or relieving factors. With this scenario, he was investigated further for abdominal pain and found to have pancreatic lipomatosis.

 


Keywords


Common bile duct, Computed tomography, Carcinoembriyonic antigen

Full Text:

PDF

References


Patel S, Bellon EM, Haaga J, Park CH. Fat replacement of the exocrine pancreas. AJR Am J Roentgenol. 1980;135(4):843-5.

Soyer P, Spelle L, Pelage JP, Dufresne AC, Rondeau Y, Gouhiri M, et al. Cystic fibrosis in adolescents and adults: Fatty replacement of the pancreas-CT evaluation and functional correlation. Radiology. 1999;210(3):611-5.

Matsumoto S, Mori H, Miyake H, Takaki H, Maeda T, Yamada Y, et al. Uneven fatty replacement of the pancreas: Evaluation with CT. Radiology. 1995;194(2):453-8.

Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444(7121):840-6.

Shimabukuro M, Zhou YT, Levi M, Unger RH. Fatty acid-induced beta cell apoptosis: A link between obesity and diabetes. Proc Natl Acad Sci U S A. 1998;95(5):2498-502.

McGarry JD. Banting lecture 2001: Dysregulation of fatty acid metabolism in the etiology of type 2 diabetes. Diabetes. 2002;51(1):7-18.

Prentki M, Nolan CJ. Islet beta cell failure in Type 2 diabetes. J Clin Invest. 2006;116(7):1802-12.

Newsholme P, Keane D, Welters HJ, Morgan NG. Life and death decisions of the pancreatic beta-cell: the role of fatty acids. Clin Sci. 2007;112(1):27-42.

Kharroubi I, Ladrière L, Cardozo AK, Dogusan Z, Cnop M, Eizirik DL. Free fatty acids and cytokines induce pancreatic beta-cell apoptosis by different mechanisms: role of nuclear factor-kappa B and endoplasmic reticulum stress. Endocrinology. 2004;145(11):5087-96.

Smits MM, vanGeenen EJ. The clinical significance of pancreatic steatosis. Nat Rev Gastroenterol Hepatol. 2011;8(3):169-77.

Lin WC, Chen JH, Lin CH, Shen WC. Rapidly progressive pancreatic lipomatosis in a young adult patient with transfusion-dependent myelodysplastic syndrome. J Formos Med Assoc. 2007;106(8):676-9.

Kim KH, Kim CD, Ryu HS, Hyun JH, Chung JP, Chung JB, et al. Endoscopic retrograde pancreatographic findings of pancreatic lipomatosis. J Korean Med Sci. 1999;14(5):578-81.

Ritz-Laser B, Meda P, Constant I, Klages N, Charollais A, Morales A, et al. Glucose-induced preproinsulin gene expression is inhibited by the free fatty acid palmitate. Endocrinology. 1999;140(9):4005-14.

Lameloise N, Muzzin P, Prentki M, Assimacopoulos-Jeannet F. Uncoupling protein 2: a possible link between fatty acid excess and impaired glucose-induced insulin secretion? Diabetes. 2001;50(4):803-9.

Bränström R, Leibiger IB, Leibiger B, Corkey BE, Berggren PO, Larsson O. Long chain coenzyme A esters activate the pore-forming subunit (Kir6. 2) of the ATP-regulated potassium channel. J Biol Chem. 1998;273(47):31395-400.

Liang Y, Buettger C, Berner DK, Matschinsky FM. Chronic effect of fatty acids on insulin release is not through the alteration of glucose metabolism in a pancreatic beta-cell line (beta HC9). Diabetologia. 1997;40(9):1018-27.

El-Assaad W, Buteau J, Peyot ML, Nolan C, Roduit R, Hardy S, et al. Saturated fatty acids synergize with elevated glucose to cause pancreatic beta-cell death. Endocrinology. 2003;144(9):4154-63.

Maedler K, Oberholzer J, Bucher P, Spinas GA, Donath MY. Monounsaturated fatty acids prevent the deleterious effects of palmitate and high glucose on human pancreatic beta-cell turnover and function. Diabetes. 2003;52(3):726-33.