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Pancreatic changes with lifestyle and age: What is normal and what is concerning?

Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany. Department of Internal Medicine, Krankenhaus Maerkisch-Oderland, D-15344 Strausberg, Germany; Brandenburg Institute of Clinical Medicine at Medical University Brandenburg, Neuruppin, Germany. Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Medical Department II, Helios Klinikum Meiningen, Meiningen, Germany. Department of Medicine and Gastroenterology, Allgemeines Krankenhaus, Celle, Germany. Department of Medical Gastroenterology, Julius-Spital Würzburg, Germany. Department of Gastroenterology and Hepatology, Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China. Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy. Department of Allgemeine Innere Medizin, Kliniken Hirslanden, Beau Site, Salem und Permanence, Bern, Switzerland.

Endoscopic ultrasound. 2023;(2):213-227
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Abstract

During the aging process, typical morphological changes occur in the pancreas, which leads to a specific "patchy lobular fibrosis in the elderly." The aging process in the pancreas is associated with changes in volume, dimensions, contour, and increasing intrapancreatic fat deposition. Typical changes are seen in ultrasonography, computed tomography, endosonography, and magnetic resonance imaging. Typical age-related changes must be distinguished from lifestyle-related changes. Obesity, high body mass index, and metabolic syndrome also lead to fatty infiltration of the pancreas. In the present article, age-related changes in morphology and imaging are discussed. Particular attention is given to the sonographic verification of fatty infiltration of the pancreas. Ultrasonography is a widely used screening examination method. It is important to acknowledge the features of the normal aging processes and not to interpret them as pathological findings. Reference is made to the uneven fatty infiltration of the pancreas. The differential diagnostic and the differentiation from other processes and diseases leading to fatty infiltration of the pancreas are discussed.

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Publication Type : Review

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