In a high percentage of cases, other organs produce different symptoms and mask inflammatory bowel disease (IBD). An exact diagnosis reveals hepatobiliary abnormalities. This was a retrospective study and its aim was to reveal hepatobiliary complications in children and adolescents with IBD. In 1987- 2001, we had 15 patients with IBD: 8 ulcerative colitis (UC), 6 Crohn's disease (CD) and 1 indeterminate colitis (IC) (mean age 12.3 years). They were investigated clinically by laboratory and microbiological (stool culture) examinations, barium radiography, lower endoscopy with histology, ultrasonography, spiral scan, flow cytometry or by operation. Ten of them had abnormalities of liver and/or gallbladder: fatty liver - 10/15 (5 UC, 5 CD), gallstone disease - 3/15 (3 CD), pericholangitis - 1/15 (1 CD), biliary cirrhosis - 1/15 (1 CD), autoimmune chronic hepatitis - 1/15 (1/15). Autoimmune abnormalities were treated by pred-nisone 2mg/kg per day, gallstone disease by ursodeoxycholic acid (Ursofalk 15 mg/kg per day; 1 case) or stone extraction (2 cases). One of the patients (biliary cirrhosis) died. In conclusion, hepatobiliary complications are common in children and adolescents with IBD. Autoimmune abnormalities are severe, difficult to treat and have a bad prognosis.
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