The records of 202 patients with chronic ulcerative colitis seen over a 12 year period were reviewed. Over one half (55 percent) were found to have liver function test abnormalities. These abnormalities correlated with the extent and severity of ulcerative colitis but not with the duration of the disease. Eight patients (4 percent) developed cirrhosis and four required portasystemic decompression for bleeding varices. Four patients (2 percent) developed biliary tract complications. Two patients were diagnosed as having sclerosing cholangitis, and two patients developed carcinoma of the extrahepatic biliary tree. Three of these four patients had whole colon involvement, but all four had mild clinical disease. It is concluded that the hepatobiliary complications of ulcerative colitis are the most frequent and serious extracolonic manifestations of the disease.
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