الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Ulcerative Colitis is an idiopathic and chronic disease characterized by diffuse inflammation of the colonic mucosa. Although the precise etiology of UC is unknown, it involves a combination of host factors and exogenous components. About 36% of UC patients have at least one EIM. Hepato-biliary manifestations are amongst the most common EIMs associated with UC. The aim of this work was to study the hepato-biliary abnormalities in patients with UC with identification of the most frequent liver insults.
The study was conducted on 60 UC patients selected from out patient clinics of the Gastro-Enterology Center and Specialized Medical Hospital, Mansoura University. They were 39 males and 21 females with age range between 18-60 years. In all the selected patients the data of detailed history, findings of clinical examination, results of investigations including laboratory, radiological, colonoscopic and histopathological examination of colonic biopsies were recorded and lastly liver biopsy and histopathological examination were done for selected patients who had sonographic hepatic changes with abnormal LFTs. According to our data, the selected patients were divided into groups depending on sonographic hepato-biliary findings, hepatic transaminases and results of liver histopathology; group 1 included 26 patients with sonographic hepato-biliary abnormalities; group 2 included 34 patients without sonographic hepato-biliary changes, group 1a included 11 patients with elevated transaminases, group 1b included 15 patients with normal transaminases; group of 6 patients with steatosis and group of 5 patients had steatosis with lymphocytic infiltrations.
From the results of the present study we concluded that: The hepato-biliary complications of UC are the most frequent and serious EIMs of the disease. Liver enlargement and liver steatosis was higher among patients with UC than mentioned in the literature for the general population. Many patients with UC had liver steatosis and increased hepatic transaminases levels. Factors increasing the probability of liver insult were long-standing disease and the presence of moderate/ severe disease activity. All patients with abnormal LFTs also had changes in US liver scan, consisting of hepatomegaly and/or dysechoic liver echo pattern. However, the same US changes were observed even in the absence of any LFTs abnormalities in 25% of UC patients. Minor abnormalities in liver tissue are common in patients with UC particularly with biochemical evidence of liver disease. It is not well known if these changes within the liver could predict a specific hepato-biliary illness in the future.