Analysis of the literature shows that extraintestinal manifestations of IBD occur in 5-20% of cases and divided into three groups: 1. Independent of inflammatory activity in the intestine (joint damage (peripheral arthritis), skin (erythema nodosum, pyoderma gangrenosum), ocular (episcleritis, uveitis, iridocyclitis) and vascular (thrombosis, embolism). 2. Do not depend on the activity of inflammation in the intestines (the defeat of the joints (ankylosing spondylitis, rheumatoid arthritis, sacroiliitis), the lesions pankreatogepatobiliarnoy system (primary sclerosing cholangitis (PSC), holangiogennaya carcinoma, autoimmune hepatitis (AIH), autoimmune pancreatitis (AIP) and skin lesions (psoriasis). 3.
The consequences of malabsorption and of inflammation (steatohepatitis, cholelithiasis, chronic pancreatitis, chronic cholecystitis, osteoporosis, anemia, amyloidosis). Hepatobiliary system and IBD. Liver and biliary tract is common in NUC and BC. Data on the frequency of liver damage in IBD is largely dependent on the completeness of the survey. In 17-27% of patients with NUC and 38% of BC was observed increased activity of transaminases and alkaline phosphatase, as well as increase the level of bilirubin.
Histological examination of biopsy specimens of liver obtained from patients with IBD showed that 50-60% of those observed moderate changes (fatty infiltration). Severe liver damage occurs in less than 3% of patients. Primary sclerosing cholangitis. If there are areas of PSC narrowing intra and extrahepatic bile ducts with their prestenoticheskim extension. It is established that patients with PSC in 70-80% of cases also have IBD, and in 12-15% patients with IBD is detected PSC. The prevalence of PSC is 2-7 cases per 100 thousand population, with men affected 2 times more often than women. It is assumed that the increased permeability of the intestinal epithelium in NUC facilitates penetration of endotoxin and toxic bacterial products into the portal vein and then into the liver. Toxins can cause periangiocholitis, impaired excretion of bile and bile duct damage. Not exclude them enterohepatic circulation. In 80-85% of patients with PSC and in 30-80% of cases in patients with IBD revealed antineutrophil cytoplasmic antibody, which is possibly a reflection of general immune mechanisms.