Article

Liver abscess in inflammatory bowel disease: Report of two cases and review of the literature

Department of Internal Medicine A, Hadassah University Hospital, Jerusalem, Israel.
Journal of Gastroenterology and Hepatology (Impact Factor: 3.63). 01/2005; 19(12):1338-42. DOI: 10.1111/j.1440-1746.2004.03368.x
Source: PubMed

ABSTRACT Hepatic abscesses are a rare complication of inflammatory bowel disease (IBD). Despite the fact that certain hepatobiliary complications of IBD, including cholelithiasis, primary sclerosing cholangitis (PSC) and cholangiocarcinoma predispose patients with IBD to ascending cholangitis, previously published data does not demonstrate that biliary infection is an important mechanism underlying liver abscess development in these patients. We describe two patients with inflammatory bowel disease, both with PSC, who developed multiple liver abscesses, and review the literature on liver abscesses in association with inflammatory bowel disease.

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    ABSTRACT: Background Extraintestinal manifestations are frequent in inflammatory bowel diseases (IBD). Most studies published so far focused on viral hepatitis and liver toxicity of IBD-related drugs.AimTo conduct a systematic review of hepatobiliary manifestations associated with IBD. We excluded viral hepatitis and liver toxicity of IBD-related drugs.Methods Studies were identified through the electronic database of MEDLINE, EMBASE and the annual meetings of Digestive Disease Week, the American College of Gastroenterology, the United European Gastroenterology Week and the European Crohn's and Colitis Organization.ResultsOne hundred and forty six articles were included in this systematic review. Cholelithiasis is more frequent in Crohn's disease (CD) than in general population. Prevalence of cholelithiasis in CD ranged from 11% to 34%, whereas it ranges from 5.5% to 15% in non-IBD patients. PSC is more frequent in UC than in CD. Prevalence of PSC ranges from 0.76% to 5.4% in UC and from 1.2% to 3.4% in CD. There is a male predominance when PSC is associated with UC, with a male/female ratio ranging from 65/35 to 70/30. No conclusion can be made on a possible increased risk of gall-bladder carcinoma. Mean prevalence of fatty liver is 23% (range, 1.5–55%). Hepatic amyloidosis occurs in less than 1% of IBD. Liver abscess is encountered mainly in CD. Portal vein thrombosis occurs in 39% to 45% of IBD patients undergoing proctocolectomy.Conclusions Hepatobiliary manifestations associated with inflammatory bowel diseases are frequent and probably underdiagnosed.
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    ABSTRACT: Hepatobiliary Diseases (HBDs) accompanies in a 5-10% of patients with Inflammatory Bowel Diseases (IBD). They are either extra-intestinal manifestations or drug side effects. The main extra-intestinal manifestation is Primary Scle-rosing Cholangitis (PSC), which as an entity, includes the former “pericholangitis”, now called small duct Primary Sclerosing Cholangitis. It mainly affects young males with ulcerative colitis. It is a chronic cholestatic disease with a broad spectrum of clinical manifestations. The asympto-matic disease has a better prognosis than the symptomatic one. It eventually leads to cirrhosis and is the 4 th cause of orthotopic liver transplantation. Cholangiocarcinoma is the most ominous complication and its presence is also accom-panied by increased frequency of colon dysplasia or can-cer. A less frequent complication is the ascending cholan-gitis with or without (pigmented) biliary stones. Auto-immune Hepatitis (type-1) is another extra-intesti-nal manifestation of IBD, but its frequency seems to be very low under the new diagnostic criteria, compared to the fre-quency reported in previous publications. An overlap syn-drome may also occur.

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