Hepatic subcapsular steatosis in diabetic CAPD patients treated with intraperitoneal insulin - Description of a typical pattern

Purpose: To describe a specific imaging pattern of hepatic fatty change typ ical of diabetic patients on continuous ambulatory peritoneal dialysis (CAP D) treated with intraperitoneal (i.p.) insulin. Material and Methods: Liver ultrasound was applied in 16 CAPD patients with insulin-dependent diabetes mellitus. Presence of hepatic subcapsular steat osis and maximum thickness of the fatty layer were recorded. Liver MR exami nation was made of 1 patient found to have extensive subcapsular steatosis. Results: Hepatic ultrasound revealed a typical pattern of subcapsular steat osis ("coating-of-fat") in 7/8 patients treated with i.p. insulin. None (0/ 8) of the diabetic CAPD patients treated with subcutaneous insulin had subc apsular steatosis. Conclusion: Hepatic subcapsular steatosis is specific to CAPD patients on i .p. insulin treatment. To our knowledge this is the first report to describ e imaging findings in this particular form of hepatic fatty change.