Boberg K M, Schrumpf E, Fausa O, Elgjo K, Kolmannskog F, Haaland T, Holter E
Medical Dept. A, Rikshospitalet, Oslo, Norway.
Scand J Gastroenterol. 1994 Aug;29(8):744-52. doi: 10.3109/00365529409092504.
The aim of the present study was to describe the characteristics of patients with ulcerative colitis (UC) and hepatobiliary disease that does not satisfy the diagnostic cholangiographic criteria of primary sclerosing cholangitis (PSC) and to compare this group with PSC patients.
Among 199 patients with UC admitted to our department during 1986-91, 64 patients had major hepatobiliary disease considered to be associated with the colitis. Biochemical tests, colonoscopy, endoscopic retrograde cholangiography (ERC), and liver biopsy were performed in these 64 patients and in 5 patients from our outpatient clinic.
PSC was diagnosed in 51 patients (group I; 80%). The other 13 patients (20%) and the additional 5 patients (n = 18; group II) all had normal extrahepatic bile ducts. Five patients in group II also had normal intrahepatic ducts, whereas 13 patients had intrahepatic abnormalities. The male to female ratio in group II was 2.0:1. All of them had extensive colitis. The clinical symptoms and the biochemical and histologic findings were quite similar in groups I and II.
The patients in group II of this study constitute a major group with hepatobiliary lesions associated with UC, amounting to one-fourth the number of PSC patients. They have several similarities with classical PSC of the large bile ducts, and we suggest that they be classified as having small-duct PSC.
本研究的目的是描述溃疡性结肠炎（UC）合并不符合原发性硬化性胆管炎（PSC）诊断性胆管造影标准的肝胆疾病患者的特征，并将该组患者与PSC患者进行比较。
在1986 - 1991年期间收治于我科的199例UC患者中，64例患有被认为与结肠炎相关的主要肝胆疾病。对这64例患者以及来自我们门诊的5例患者进行了生化检查、结肠镜检查、内镜逆行胆管造影（ERC）和肝活检。
51例患者被诊断为PSC（I组；80%）。另外13例患者（20%）以及额外的5例患者（共18例；II组）肝外胆管均正常。II组中有5例患者肝内胆管也正常，而13例患者有肝内异常。II组中男女比例为2.0:1。他们均患有广泛性结肠炎。I组和II组的临床症状、生化及组织学表现相当相似。
本研究中的II组患者构成了与UC相关的肝胆病变的主要群体，数量达PSC患者的四分之一。他们与经典的大胆管PSC有若干相似之处，我们建议将他们归类为小胆管PSC。
