Impact of Fatty Liver on Acute Pancreatitis Severity

Abstract

Aim. Acute pancreatitis is typically a mild disease, but some patients develop severe courses. Fatty liver changes are seen in patients with acute pancreatitis, but its clinical significance has not been well-studied. We aimed to investigate the relationship between fatty liver and the severity of acute pancreatitis. Methods. Unenhanced CT images of patients with acute pancreatitis were retrospectively reviewed by a radiologist, and mean hepatic and splenic attenuation was measured in Hounsfield units (HU). Fatty liver was defined as mean hepatic/splenic HU < 1. Results. Among 200 patients, fatty liver was found in 67 (33.5%) and nonfatty liver in 133 (66.5%). Compared with patients without fatty liver, the severity of pancreatitis and levels of serum C-reactive protein were higher in fatty liver patients. The prevalence of local complications, persistent organ failure, and mortality were also higher in patients with fatty liver. Even after adjusting for age, sex, body mass index, and cause of pancreatitis, fatty liver was significantly associated with moderately severe or severe acute pancreatitis. Conclusions. Fatty liver may play a prognostic role in acute pancreatitis. Fatty liver could be incorporated into future predictive scoring models.

Fatty Liver Disease and Non-Alcoholic Fatty Liver Disease Worsen the Outcome in Acute Pancreatitis: A Systematic Review and Meta-Analysis

“…Sensitivity analysis, except for one outcome, showed no significant difference. When we removed the study of Yoon et al [ 37 ] from the forest plot with the odds of pancreatic pseudocyst, the results became non-significant (OR = 2.09; CI: 0.97–4.55).…”

“…Guidelines recommend performing a contrast-enhanced CT scan within 72 h–96 h after the onset of the AP symptoms [ 6 ]. Combined unenhanced and enhanced CT scans may be useful in assessing the status of both AP and FLD [ 37 ]. Studies that used CT scan and US or other methods (US elastography, MRI, etc.)…”

“…Significant heterogeneity could be observed among the cause of AP and FLD. According to Yoon et al [ 37 ], a strong trend between the presence of FLD and AP severity was observed regardless of the cause of pancreatitis (alcoholic vs. non-alcoholic). Xu et al [ 18 ] have found no difference in AP severity when comparing alcoholic FLD with NAFLD.…”

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

“…There have been several studies on the association between fatty liver and AP, namely with the severity of AP [81]. Yoon et al [95], in their study investigating the relationship between fatty liver and the severity of AP, verified that fatty liver may play a prognostic role in this disease and could be incorporated into future predictive scoring models.…”

Relationship between Fatty Liver and Pancreatitis

“…It was suggested that CT plain scan should be completed within 12 hours after emergency treatment to evaluate the extent of exudation of pancreatitis. At the same time, other acute abdomen can also be dis-International Journal of Clinical Medicine tinguished [1]. By morphological features, the range of peripancreatic fluid accumulation and pancreatic necrosis can be effectively distinguished.…”