ULCERATIVE COLITIS AND INTRAHEPATIC CHOLESTASIS

Abstract

Background. Ulcerative colitis (UC) is an inflammatory bowel disease with unpredicted clinical course and outcomes. Histology is an important part of UC diagnosis and plays an increasing role in management of patients, since more and more histological signs with prognostic value are being identified and confirmed. Objective. To describe a clinical case of death of a UC patient with intrahepatic cholestasis. Material and methods. The article presents autopsy and pathology findings in UC. Results. A patient admitted to the hospital for unspecified acute hepatitis, nonspecific ulcerative colitis and gastrointestinal bleeding died because of ulcerative colitis complicated by sclerosing cholangitis. The course of ulcerative colitis was complicated by bleeding from ulcerated areas; by intrahepatic and extrahepatic cholestasis as well as necrosis of hepatocytes associated with sclerosing cholangitis; by the development of hepatorenal syndrome and sepsis, that resulted in fatal outcome. Conclusions. Multiple severe disturbances occurring in UC pathogenesis result in mutual aggravation syndrome involving interaction of pathophysiological processes with subsequent patient's condition deterioration as well as increased risk of complications and death.