Extraintestinal Manifestations in Inflammatory Bowel Disease: A Retrospective Observational Study in a Peruvian Tertiary Hospital.

Background and Objectives: Extraintestinal manifestations (EIMs) are clinically relevant components of inflammatory bowel disease (IBD), but real-world data from Latin American referral settings remain limited. This study aimed to estimate the frequency and pattern of documented EIMs and identify associated factors in a Peruvian tertiary-care cohort. Materials and Methods: We conducted a retrospective analytical study at the Gastroenterology Service of Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru. Adults with confirmed IBD attended between April 2020 and February 2025 were included (n = 162). EIMs were defined as documented articular, dermatologic, or ocular involvement. Crude and adjusted odds ratios (ORs and aORs) with 95% confidence intervals (CIs) were estimated using logistic regression. Results: The mean age was 50.6 ± 18.3 years, 54.9% were female, and 71.0% had ulcerative colitis. Overall, 16.7% of patients had at least one documented predefined EIM. Articular involvement was the most frequent manifestation (11.7%), whereas dermatologic and ocular manifestations each accounted for 2.5%. In the exploratory adjusted model, the harmonized Montreal category 3 retained a statistically significant association with documented EIMs (aOR 3.12, 95% CI 1.19-8.18; p = 0.021). Conclusions: In this Peruvian tertiary IBD cohort, documented EIMs affected a meaningful minority of patients and were predominantly articular. The harmonized Montreal category 3 was associated with documented EIMs and may help flag patients for more targeted systemic and multidisciplinary assessment, although this exploratory finding requires external validation.