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* = Presenting author

P715 Hepatobiliary and pancreatic manifestations in patients with inflammatory bowel disease: retrospective study from north-western Greece

F. Fousekis*, K. Katsanos, D. Christodoulou, E. Tsianos

Medical school, university of Ioannina, Internal medicine and hepatology & gastroenterology, Ioannina, Greece

Background

Hepatobiliary and pancreatic manifestations are not infrequently in patients with Crohn’s disease or ulcerative colitis. The manifestations are a result of the disease itself and medications used in the treatment. The aim of this study was to describe the prevalence of hepatobiliary and pancreatic manifestations in inflammatory bowel disease.

Methods

The study included 520 patients with IBD who were monitored from 1974 to 2013. Data were retrospectively extracted from the clinical records of patients followed in the university hospital in Ioannina, Greece.

Results

In total, 53.5% of IBD patients have UC; 38.5% CD; and 8% indeterminate colitis (IC). The mean follow-up of patients was 5.8 years (SD 6.72). Further, 42% (220/520) of patients had imaging evaluation. From them, the imaging revealed findings in 120 patients. The manifestations/ findings from liver were fatty liver, viral hepatitis haemangioma, cysts, ischemic hepatitis, multiple liver abscesses, fibrosis, and primary biliary cirrhosis. The most common hepatic finding was fatty liver (44 cases). The biliary manifestations included cholelithiasis, primary sclerosing cholangitis, cholecystitis, polyps in the gallbladder, and cholangiocarcinoma. The most frequent manifestation was cholelithiasis (32 cases). The pancreatic manifestations included 4 patients with acute pancreatitis and 1 with chronic pancreatitis. Over 200 patients from 520 were tested for antibodies against hepatitis B and C, and 5.3% had hepatitis B and 13.4% had past HBV infectious. In addition, most patients were not immune against hepatitis B (32% were anti-HBs positive). About hepatitis C, 3% of patients were anti-HCV positive, but only 1 patient had active hepatitis C. Moreover, 23 patients had side effects affecting the liver and pancreas. The side effects included 18 hepatotoxicity, 3 acute pancreatitis, and 2 elevated amylase. In addition, there were 2 patients with HBV reactivation, and 1 exacerbation HCV infectious, and all 3 patients received immunodulators.

Conclusion

Hepatobiliary and pancreatic manifestations in patients with IBD are frequently. In our study, 1 of 4 patients had some manifestation because of the disease itself or medication. For this reason, we should monitor liver function at regular intervals, and differential diagnosis should range from benign diseases and side effects to malignant disorders such as primary sclerosing cholangitis. Additionally, we should not forget the low immunogenicity of IBD patients and HBV reactivation.