Enlargement of the pancreas in non-alcoholic cirrhosis: a computed tomography and pathological investigation

To evaluate the effect of hepatic dysfunction on pancreatic morphology, the antero-posterior width of the pancreas was measured by CT in 50 non-alcoholic cirrhotic patients without pancreatic disease and 221 age-and sex-matched normal controls. In addition, we reviewed the histology of the pancreas from 13 autopsies of the cirrhotics and 13 controls. The mean width of the pancreatic head in the cirrhotics was 2.94 0.34 cm (mean SD), which was significantly larger than that in the controls (2.17 0.32 cm) (P < 0.001). The width of the pancreatic body in the cirrhotics was also significantly greater than in the controls (1.95 0.24 cm versus 1.50 0.30 cm) (P < 0.001). Histological investigation revealed that lipomatosis and fibrosis increased with age in the controls, while they were seldom observed in the cirrhotics. And enlargement of acinar cells or of the islets of Langerhans was often seen in the cirrhotics. These data suggested that advanced liver dysfunction provoked pancreatic growth, probably through a trophic effect.Offprint requests to: T. Muranaka