Letters To The Editor
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World J Gastroenterol. Apr 21, 2011; 17(15): 2061-2062
Published online Apr 21, 2011. doi: 10.3748/wjg.v17.i15.2061
Pancreatic hyperechogenicity on endoscopic ultrasound examination
Yucel Ustundag, Guray Ceylan, Koray Hekimoglu
Yucel Ustundag, Guray Ceylan, Zonguldak Karaelmas University School of Medicine, Department of Internal Medicine, Gastroenterology Clinics, Zonguldak 67100, Turkey
Koray Hekimoglu, Baskent University School of Medicine, Department of Radiology, Ankara 06100, Turkey
Author contributions: Ustundag Y and Ceylan G evaluated the paper and contributed to all of this work; Hekimoglu K analyzed and interpreted the paper with regard to the radiologic findings in a fatty pancreas.
Correspondence to: Guray Ceylan, MD, Zonguldak Karaelmas University School of Medicine, Department of Internal Medicine, Gastroenterology Clinics, Zonguldak 67100, Turkey. gurayceylan@yahoo.com
Telephone: +90-537-2616655 Fax: +90-372-2610155
Received: November 15, 2010
Revised: February 15, 2010
Accepted: December 22, 2010
Published online: April 21, 2011
Abstract

There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the more appropriate methods to diagnose pancreatic hyperechogenicity when compared with transcutaneous or endoscopic ultrasound examination. More importantly, pancreatic hyperechogenicity may not be a certain indicator of pancreatic fat infiltration. Even if it is true, we do not know the clinical significances of pancreatic fat accumulation. Some suggested that excess fat in the pancreas is associated with chronic pancreatitis. However, several histological studies on human alcoholic chronic pancreatitis did not prove the presence of fatty pancreas in such cases. Thus, except for aging, it is very rare to have truly steatotic pancreas in the absence of certain human diseases.

Keywords: Hyperechogenic pancreas; Fatty pancreas; Endoscopic ultrasound; Aging; Chronic pancreatitis