Hepatobiliary alterations in inflammatory bowel disease in pediatrics

Abstract

Background: Inflammatory bowel disease includes Crohn's disease, ulcerative rectocolitis and indeterminate colitis, whose evolution is chronic and fluctuating, and present various extraintestinal manifestations, mainly in the hepatobiliary tree Objective: To describe the hepatobiliary alterations of inflammatory bowel disease in patients pediatric patients of the Gastroenterology clinic of the JM De Los Ríos Hospital, during the period 2002-2023. Patients and Methods: Descriptive, observational, ambispective, cross-sectional study; patients diagnosed with inflammatory bowel disease between the ages of 2 and 18 years are included; who met inclusion criteria for IBD; Obtaining the information through medical records. The data was analyzed by descriptive statistics; mean, median and percentages Results: 33 patients diagnosed with IBD: RCU 22/33 (67%), CD 10/33 (30%) and CI 1/33 (3%). The average age of debut was 10 years. We found extra intestinal manifestations in 30/33 (91%); Hepatobiliary alterations being the most frequent 15/33 (45%), predominantly transient hypertransaminasaemia 12/15 (80%), followed by primary sclerosing cholangitis (PSC), 2/15 (13%) and gallbladder lithiasis 1/15 (7 %). The ultrasound findings were; diffuse liver parenchymal process 9/15 (60%), hepatomegaly 3/15 (20%), ascites 1/15 (7%), periportal fibrosis 1/15 (7%), and gallstones 1/15 (7%) . 47% of the patients had a severe IBD clinical activity index at the time of the hepatobiliary alterations. Conclusion: Extraintestinal complications in IBD are common; including liver and biliary tree involvement. Clinical and paraclinical evaluation is important in order to obtain a timely diagnosis and establish an early treatment that avoids other complications and manages to optimize the quality of life of patients in this age group.