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Prediction of free bowel perforation in patients with intestinal Behçet's disease using clinical and colonoscopic findings.

 Chang Mo Moon  ;  Jae Hee Cheon  ;  Jae Kook Shin  ;  Soung Min Jeon  ;  Hyun Jung Bok  ;  Jin Ha Lee  ;  Jae Jun Park  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Nam Kyu Kim  ;  Won Ho Kim 
 Digestive Diseases and Sciences, Vol.55(10) : 2904-2911, 2010 
Journal Title
 Digestive Diseases and Sciences 
Issue Date
BACKGROUND: Gastrointestinal tract involvement in Behçet's disease (BD) often requires surgical intervention due to serious complications such as intestinal perforation, fistula formation, or massive bleeding. AIM: The aims of this study were to investigate the clinical and surgical features of free bowel perforation and to determine the risk factors associated with this complication in intestinal BD patients. METHODS: We reviewed the medical records of 129 patients with intestinal BD treated from September 1988 to September 2008. Among them, 33 patients had intestinal perforations and all underwent emergent or elective laparotomy. RESULTS: The mean age of the patients with bowel perforation was 34.8 ± 15.6 years (range 12-70 years) with a sex ratio of 2.3:1 (male:female). Twenty-seven (81.8%) patients were diagnosed with intestinal BD preoperatively, whereas six (18.2%) patients were diagnosed by pathological examination after operation. Fourteen (42.4%) patients experienced postoperative recurrence of intestinal BD and 11 (33.3%) underwent reoperation. Multivariate Cox hazard regression analysis identified younger age (≤ 25 years) at diagnosis (HR = 3.25; 95% CI, 1.41-7.48, p = 0.006), history of prior laparotomy (HR = 5.53; 95% CI, 2.25-13.56, p = 0.0001), and volcano-shaped intestinal ulcers (HR = 2.84; 95% CI, 1.14-7.08, p = 0.025) as independent risk factors for free bowel perforation in intestinal BD. CONCLUSIONS: According to the results of our study, patients diagnosed with intestinal BD younger than 25 years, who had a history of prior laparotomy or volcano-shaped intestinal ulcers have an increased risk of free bowel perforation.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김남규(Kim, Nam Kyu) ORCID logo https://orcid.org/0000-0003-0639-5632
김원호(Kim, Won Ho) ORCID logo https://orcid.org/0000-0002-5682-9972
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
문창모(Moon, Chang Mo)
박재준(Park, Jae Jun)
복현정(Bok, Hyun Jung)
신재국(Shin, Jae Kook)
이진하(Lee, Jin Ha)
천재희(Cheon, Jae Hee) ORCID logo https://orcid.org/0000-0002-2282-8904
홍성필(Hong, Sung Pil)
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