Liver lesions in inflammatory bowel disorders
Liver lesions in inflammatory bowel disorders
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炎症性肠病中的肝脏病变
作者：
V. Desmet;K. Gebooes;Universitair Ziekenhuis St;Laboratorium Rafael;voor Histo
胃肠道疾病累及肝脏并不罕见。基本上，有两种机制可以解释肝脏并发症。可以想象，肝脏疾病继发于肠道疾病。因此，肾盂炎和肾盂脓肿可能继发于阑尾炎和憩室炎。但也有可能肝脏疾病和肠道疾病是由一个共同的原因（如小肠结肠炎耶尔森菌感染）或其他机制引起的，因此肝脏疾病和肠道疾病是两个不同的器官表达一个共同的潜在机制，如免疫机制失调。后者是目前最可信的理论，如溃疡性结肠炎与原发性硬化性胆管炎相关。这篇关于炎症性肠病中的肝脏疾病的综述将主要考虑特发性炎症性肠病的病理方面，吸收不良综合征和医源性疾病。
Hepatic involvement in diseases of the gastro-intestinal tract is not uncommon. Basically, two mechanisms may explain liver complications. It is conceivable that liver disease is secondary to bowel disease. Thus pylephlebitis and pylephlebitic abcesses may be secondary to appendicitis and diverticulitis. But it is also possible that liver disease and bowel disorders are due to a common cause e.g. Yersinia enterocolitica infection’ or other mechanisms, so that liver disease and bowel disease are two different organ expressions of a common underlying mechanism, e.g. dysregulation of immune mechanisms. The latter is at present the most plausible theory for entities like ulcerative colitis associated with primary sclerosing cholangitis. This review on liver diseases in inflammatory bowel disorders will consider mainly pathological aspects of idiopathic inflammatory bowel disease, malabsorption syndromes and iatrogenic conditions.