위 및 전 소장을 침범하고 말단 회장 천공을 동반한 Behcet 병 1예

Abstract

Behcet's syndrome is a multisystemic, chronic inflammatory disease with triad of oral ulcer, genital ulcer and inflammatory ocular lesion. Intestinal Behcet's disease accounts for 1-2% of Behc'ets disease and most commonly affects the ileocecal region as ulcerations. A 70-year-old male patient was admitted to this hospital because of melena for 5 days. There was a history of recurrent aphthous stomatitis and genital ulcer. Colonoscopy showed multiple, irregularly, rnarginated, ellipsoid ulcers surrounded by hyperemic mucosa with vessel exposure on terminal ileum. Esophagogastroduodenoscopy showed multiple, round punched out ulcers on antrum and duodenal bulb. He was taken the near total small bowel resection, right hemicolectomy and ileotransverse colostomy because of hemorrhage and terminal ileal perforation. Three days after operation, melena reappeared and esopbagogastoduodenascopy revealed bleeding from duodenal ulcers and impending perforation of antral ulcer. He was reoperated with antrectomy, truncal vagotomy and gastroduodenostomy. Resected small bowel was 510 cm in length and there were multiple small round transverse ulcers surrounded by hyperemic edematous elevated rnucosa. Three 'punch-out ulcers' were also found on resected gastric antrum. So, we report a case of gastrointestinal Behcet's disease involving stomach, duodenum, jejunum and ileum with terminal ileum perforation. (Korean J Gastrointest Endosc 17: 541-547, 1997)