Hepatobiliary manifestations of inflammatory bowel disease

A large number of hepatobiliary abnormalities have? been described in assoc iation with inflammatory bowel disease (IBD) including primary sclerosing c holangitis (PSC), pericholangitis, chronic hepatitis, cryptogenic cirrhosis , cholangiocarcinoma, and cholelithiasis. PSC is the most common of these h epatobiliary diseases. This high degree of association with IBD suggests a common pathogenic mechanism; however, no causal relationship has been estab lished between the two conditions. Medical therapy has not proven successfu l in slowing disease progression or prolonging survival. Endoscopic manipul ation is recommended for treating complications of recurrent cholangitis or worsening jaundice in the setting of a dominant stricture, but endoscopic approaches have not been shown to improve survival or decrease the need for liver transplantation.