The Landscape of Medical Disputes in Inflammatory Bowel Disease: A Nationwide Retrospective Study Based on China Judgments Online

Abstract Background and Aims: Inflammatory bowel disease (IBD) requires lifelong management, and treatment-related adverse events are difficult to avoid, rendering it a potential source of medical disputes. This study aimed to analyze the characteristics and influencing factors of IBD-related medical disputes using national judgment documents. Methods: A retrospective search of China Judgments Online was conducted for concluded medical damage liability dispute cases involving IBD through December 2025. After screening, 62 cases were included. Data on case timing, region, patient characteristics, dispute reasons, liability, and compensation were extracted. Descriptive statistics and Spearman’s correlation were used. Results: The 62 disputes (2014–2025) peaked in 2018 (9 cases) and declined thereafter. Cases concentrated in East China, led by Jiangsu (12.9%), Henan (9.7%), and Hebei (8.1%). Patients were predominantly male (64.9%), median age 46 years. Ulcerative colitis (50.0%) and Crohn's disease (35.5%) were the main diagnoses. Surgical treatment was involved in 65.5% of cases; overall mortality was 38.6%. Delayed treatment was the most frequent alleged error (15 cases). Breach of duty of care was significantly correlated with patient death (r=0.31, P=0.017). Medical institutions were found liable in 80.6% of cases, with median compensation of 167,709.65 CNY. Conclusions: Medical institutions bear a very high proportion of liability in IBD-related disputes, with delayed treatment and breach of duty of care as core risk factors, the latter closely associated with inpatient mortality. These findings underscore the need to enhance early recognition of IBD, strengthen monitoring of severe patients, and standardize procedures to reduce litigation at the source.