Recompensation is reshaping how we understand cirrhosis, but key gaps remain.
Join @salvatore_piano, @elizabeth_verna, and @DrLoomba in two weeks to explore how etiological control enables recompensation, what defines it clinically, and how outcomes may shift for patients. Save your seat: https://t.co/ejuDA5Zt6G
There was so much talk about the protests in Iran – but they drowned in blood. The world has not helped enough the Iranian people, it has stood aside.
What will Iran become after this bloodshed? If the regime survives, it sends a clear signal to every bully – kill enough people, and you stay in power.
💡 Fatty pancreas is emerging as one of the next major metabolic diseases, yet it remains vastly under-recognized.
Over the past several years, our team at Baylor College of Medicine (BCM) and Baylor St. Luke’s Medical Center has closely studied the rise of diffuse pancreatic echogenicity, commonly termed fatty pancreas. Much like fatty liver disease, its prevalence is climbing, but its clinical consequences remain underappreciated.
Our earlier BCM study demonstrated that diffuse pancreatic echogenicity is not a benign incidental finding. It can be associated with exocrine pancreatic insufficiency (EPI), subtle parenchymal injury, and may represent an early step toward chronic pancreatitis.
PMID: 34350519
📘 Today, I’m proud to share our newest publication @EJ_Gastro_Hep, led by Dr. Tara Keihanian and me, with contributions from the BCM Advanced Endoscopy team.
In this study, we propose a novel EUS-based classification system that captures three distinct and reproducible patterns of fatty pancreas—patterns that clinicians often miss unless they are trained to recognize them.
https://t.co/znfYIszXQq
Across 238 patients evaluated at BCM/Baylor St. Luke’s, we identified:
1️⃣ Type I – Early “Mottled Pattern”
Diffuse echogenicity with patchy hypoechoic islands representing fat-sparing.
2️⃣ Type II – Homogeneous Fatty Pancreas (Most Common)
Uniform diffuse echogenicity without sparing.
3️⃣ Type III – “Cotton Candy Appearance”
Fatty infiltration extending beyond pancreatic borders, producing a fluffy echotexture.
Despite their visual differences, all three patterns demonstrated similar prevalence of diabetes, fatty liver, and EPI, supporting the concept that fatty pancreas is a continuum with shared metabolic implications.
🧭 Why this matters
*Fatty pancreas is widely underdiagnosed. A standardized visual framework allows clinicians to:
Detect the condition earlier
*Identify metabolic risk sooner
*Recognize subtle fibrotic changes that may signal early chronic pancreatitis
*Build a foundation for future staging and targeted management
What’s Next at BCM
Our next step is to perform external validation of this classification system.
We will be:
Creating a training set and exam (testing) set of EUS images
Evaluating interobserver agreement across multiple centers
Calculating Cohen’s kappa values to measure reproducibility
Refining definitions and thresholds to ensure wide applicability
This structured validation approach will help determine how well the classification performs outside our center and whether it can be adopted broadly as a reliable diagnostic framework.
If your institution is interested in participating in the validation phase, please contact me at: [email protected]
The @AASLDtweets is hosting a new one day intensive session 'Liver Care for Frontline Clinicians: From Assessment to Intervention'
Goal: Provide practical strategies for primary care for managing patients with liver disease
🗓️ March 14, 2026
📌 Las Vegas
https://t.co/Z9uOlsliIM
🇹🇷Antalya, Turkey for the 42nd National GI Week - an inspiring time with global #WomenInGI - education, connection, & sisterhood
🌍Together we grow, impact, & improve our field. #UGH2025, community, & culture were fantastic - vow to strength & momentum of our #GlobalGICommunity
🙏🏼Grateful to @TGDGastro & Pres Prof Dilek Oğuz for the invite, & to Prof Ayşe Nurdan Tözün, whose vision & advocacy made it possible
👏Welcome to our incoming GI fellows! We’re thrilled to have you join our team and can’t wait to see all you’ll accomplish.
Congratulations and cheers to an amazing journey ahead! 🎉
#gimatch#MATCHDAY#Match2026
Honored to receive @CrohnsColitisOH Bing Hinton Legacy Award 🙏🏼
Grateful to my patients, team, colleagues @UCincyMedicine@uc_health for walking this journey w/ me.
Legacy isn't what we leave behind, it's what we build now.
We lead with purpose
We serve with impact
Let's go🥊
Anahita Rabiee of @YaleMed presented on recompensation in #cirrhosis at #TLM2025
- Baveno VII definition includes ascites off any diuretics
- About 1 in 3 develop recompensation with etiologic treatment
- Risk of #HCC persists
#portalHTN
Kicking off #AASLD2025 with our poster presentation: An Interim Update from the Dallas Dionysus Study — a prospective cohort exploring early-stage MetALD and ALD
Great work by @Eliasrady_MD & the team! Excited for a weekend of science, inquiry, and connection
#TLM2025#LiverX
Announcing the 2025 Diversity, Equity, and Inclusion Award:
Aline Charabaty, MD, FACG, for her passion for education and her advocacy for the GI profession and for the underrepresented
Congratulations, Dr. Charabaty!
@DCharabaty#ACG2025
⭐️ Step into your future in GI & Hepatology ⭐️
Applying to GI this cycle and interested in Hepatology?
Join us for a webinar with fellows & program directors sharing practical insights on preparing for fellowship
🎯 Register here: https://t.co/gHYzX99V4s
@AASLDtweets