P109 The prevalence of liver, biliary tract and pancreas abnormalities in patients with Inflammatory Bowel Disease screened by US and confimed by echoendoscopy
M. Basaranoglu*1, 2, M. Yuksel3, O. Coskun3, M. Kaplan2, M. Ozdemir4, N. Turhan5, A. Aksoy2
1Bezmialem University, Gastroenterology, Istanbul, Turkey, 2Türkiye Yuksek Ihtisas Hospital, Gastroenterology, Ankara, Turkey, 3Türkiye Yüksek Ihtisas, Gastroenterology, Ankara, Turkey, 4Türkiye Yuksek Ihtisas Hospital, Radiology, Ankara, Turkey, 5Türkiye Yuksek Ihtisas Hospital, Pathology, Ankara, Turkey
It was reported that involvement of the pancreas, liver and biliary tract, including the gallbladder is rare in patients with inflammatory bowel disease (IBD). More specifically, pancreas pathologies were not well defined in patients with IBD, so far. Our aim to find the prevalance of these involvements by using transabdominal ultrasound (US). Additionally, we further characterized pancreas abnormalities by echoendoscopy (EUS).
We evaluated our IBD clinic's records which includes 2700 patients with IBD. We used US to show pancreas, liver and biliary tract abnormalities. Then, patients with pancreas abnormalities were further examined by EUS. Patients with recent onset dyspepsia were used as a control group.
Of the 2700 patients with IBD, 835 had documented US Results. There was 162 patients without IBD as a control. All of the patients, 59% in IBD and 58% in control were male. The prevalence of abnormalities as follows: liver steatosis, 40% in IBD vs 45% in controls (p> 0.05); gallbladder polip, 2.4% in IBD vs 8% in controls (p> 0.05); gallbladder sludge&stone, 8.4% in IBD vs 9.9% in controls (p> 0.05); hepatomegaly, 9.7% in IBD vs 25.3% in controls (p< 0.001); gallbladder operation, 4.4% in IBD vs 7.4% in controls (p< 0.001); gallbladder pathologies (polip, sludge, and operation), 15.1% in IBD vs 22.2% in controls (p= 0.024); gastric antrum wall tickness, 0.5% in IBD vs 1.9% in controls (p> 0.05); hepatic simple cyst, 1.6% in IBD vs 2.5% in controls (p> 0.05); hemangioma, 2.8% in IBD vs 1.9% in controls (p> 0.05); pancreas parancyhmal abnormalities, 5.3% in IBD vs 0.6% in controls (p= 0.009); chronic liver disease findings, 2.2% in IBD vs 0% in controls (p: 0.057); hepatic calcification, 1.0% in IBD vs 0.6% in controls (p> 0.05). Of the 44 patients with paranchymal changes in pancreas, EUS investigation was performed in 13. EUS showed major A or B with minor single finding according to the Rosemont classification. The presentation of the disease was autoimmune pancreatitis (AIP) in 3 patients; acute pancreatitis in two; without any symptom in 6 patients. Echoendoscopy findings as follows: The size of the main duct was dilated up to 5.0 mm; pancreas atrophy in 2 patients; sausage-shaped enlargement in 2 patients with AIH; honey comb appearence in 10 patients, hyperechogen stria in the head of the pancreas in 6 patients.
Our Results showed that involvement of the pancreas, liver and biliary tract not frequent, but also not a rare finding in patients with IBD. Chronic paranchymal changes of the pancreas are underestimated and should be followed for any progress in clinical practice.