Toxicity and perforation, obstruction -whether it s due to benign strictures or malignant complications. Abscess formation which may be abdominal, perianal or perirectal. Here s an illustration of toxicity in the colon. On the left - There are complications of inflammatory bowel disease related to chronic inflammation, and the systemic complications are glomerulonephritis and amyloidosis related to the elevated inflammatory proteins and immune complexes. This is relatively uncommon now that we have better treatments.
Local complications are still common.
The vascular complications, such as thrombophlebitis, erythema nodosum and pyoderma gangrenosum, the chronic skin lesions. There are systemic complications that do not resolve with treatment of the underlying inflammatory bowel disease, and important among these is the central or axial arthritis which is related HLA B-27 positivity. Here you can see an extensive ankylosis of the spine and the surgical clips from the colectomy, which did not help the spine. This is a lateral view of the same thing. Similarly, liver and bile duct lesions tend to follow their own course and can include anything from fatty change to chronic active hepatitis, sclerosing cholangitis and cholangiocarcinoma.