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March 8, 1965

The Spectrum of Cholestatic Hepatic Disease

Author Affiliations

From the Section of Medicine (Drs. Stauffer, Sauer, and Dearing) and the Section of Experimental and Anatomic Pathology (Dr. Baggenstoss), Mayo Clinic and Mayo Foundation, Rochester, Minn.

JAMA. 1965;191(10):829-837. doi:10.1001/jama.1965.03080100047011

Hepatic disease has long been a well-documented but rare complication of chronic ulcerative colitis. Early reports, mainly from necropsy studies, showed the hepatic lesions most frequently to be either fatty liver or some form of cirrhosis. During the past 12 years, there have been two important changes in the study of this relationship: (1) increased recognition that liver-function tests give abnormal results in many patients with chronic ulcerative colitis,1 and (2) increased observation of patients with prolonged hepatic injury characterized by cholestatic features. In some of these patients the lesion progresses to cirrhosis, often exhibiting clinical and laboratory characteristics of the "biliary" type.1-3

Two reports in 19521,4 initiated a changing concept in identifying the hepatic lesions seen with ulcerative colitis. Kleckner and co-workers1 reported on patients with ulcerative colitis and chronic jaundice, "pericholangitis with bile stasis" noted on hepatic biopsy, and clinical and laboratory data suggesting a