Intrapancreatic Fat Deposition: Cause or Consequence of First Acute Pancreatitis Attack?

Considering the scientific evidence\r\nnowadays available, we suggest that IPFD\r\nshould be carefully differentiated between\r\npancreatic fat accumulation (an overflow of\r\nfat in the pancreas in patients with adipose\r\nexcess) and fatty replacement (characterized\r\nby a change in the cellular identity with an\r\nacinar-to-adipocyte transdifferentiation in\r\npatients with pancreatic damage, such as\r\nAP). Different from the conclusions of the\r\nauthors of this study, we believe that fatty\r\nreplacement is not the “first hit” predisposing\r\nto pancreatic disease, but the “second hit”\r\ndriving to pancreatic meta-inflammation\r\nand chronic damage (Figure 1).