THE ROLE of the pancreas in fat metabolism has occupied the attention of both clinician and investigator since Fisher's1 demonstration in 1924 that pancreatectomized dogs maintained on insulin succumbed with fatty livers to a condition other than diabetes.
Parenteral injection of ethionine, which specifically produces necrosis of the acinar cells of the pancreas, resulted in fatty livers in female rats.2
Ivy3 has raised the question whether such changes ever occur in the human subject.
Numerous reports in the literature, however, suggest that pancreatic disease may result in pathological liver changes in man, as well as in animals.
Portal cirrhosis of the liver has been reported in association with pancreatic lithiasis by Feissinger and Olivier,4 Valléry-Radot5 and co-workers, and Witherspoon.6
Roux7 described a man with pancreatic lithiasis who had an enlarged fatty liver with ascites. Improvement occurred in the ascites when the patient was