HEPATOBILIARY DISEASE IN ULCERATIVE-COLITIS - AN ANALYSIS OF 18 PATIENTS WITH HEPATOBILIARY LESIONS CLASSIFIED AS SMALL-DUCT PRIMARY SCLEROSING CHOLANGITIS

Background: The aim of the present study was to describe the character istics of patients with ulcerative colitis (UC) and hepatobiliary dise ase that does not satisfy the diagnostic cholangiographic criteria of primary sclerosing cholangitis (PSC) and to compare this group with PS C patients. Methods: Among 199 patients with UC admitted to our depart ment during 1986-91, 64 patients had major hepatobiliary disease consi dered to be associated with the colitis. Biochemical tests, colonoscop y, endoscopic retrograde cholangiography (ERC), and liver biopsy were performed in these 64 patients and in 5 patients from our outpatient c linic. Results: PSC was diagnosed in 51 patients (group I; 80%). The o ther 13 patients (20%) and the additional 5 patients (n = 18; group II ) all had normal extrahepatic bile ducts. Five patients in group II al so had normal intrahepatic ducts, whereas 13 patients had intrahepatic abnormalities. The male to female ratio in group II was 2.0:1. All of them had extensive colitis. The clinical symtoms and the biochemical and histologic findings were quite similar in groups I and II. Conclus ions: The patients in group II of this study constitute a major group with hepatobiliary lesions associated with UC, amounting to one-fourth the number of PSC patients. They have several similarities with class ical PSC of the large bile ducts, and we suggest that they be classifi ed as having small-duct PSC.