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

Authors
 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 
Citation
 Digestive Diseases and Sciences, Vol.55(10) : 2904-2911, 2010 
Journal Title
 Digestive Diseases and Sciences 
ISSN
 0163-2116 
Issue Date
2010
MeSH
Adolescent ; Adult ; Age Distribution ; Aged ; Asian Continental Ancestry Group/statistics & numerical data* ; Behcet Syndrome/ethnology* ; Behcet Syndrome/pathology* ; Behcet Syndrome/surgery ; Child ; Colonoscopy ; Female ; Humans ; Intestinal Perforation/ethnology* ; Intestinal Perforation/pathology* ; Intestinal Perforation/surgery ; Kaplan-Meier Estimate ; Laparotomy/statistics & numerical data ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Risk Factors ; Ulcer/epidemiology ; Ulcer/pathology ; Young Adult
Keywords
Behçet disease ; Intestines ; Intestinal perforation ; Risk factors
Abstract
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.
Full Text
http://link.springer.com/article/10.1007%2Fs10620-009-1095-7
DOI
10.1007/s10620-009-1095-7
Appears in Collections:
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
7. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Moon, Chang Mo(문창모)
Park, Jae Jun(박재준)
Bok, Hyun Jung(복현정)
Shin, Jae Kook(신재국)
Lee, Jin Ha(이진하)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101652
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