1999 Volume 32 Issue 5 Pages 1222-1226
We report a case of intestinal Behcet's disease treated only by simple closure of perforated lesions in the cecum and the ascending colon. A 26-year-old man had suffered from fever and sore throat since February 20, 1995. Four days later he was admitted to our hospital with an oral aphtoid ulcer and skin eruptions at his chest. On the fifth day after admission he suddenly complained of right lower abdominal pain. The next day an emergency operation was carried out under a diagnosis of bowel perforation. There were two perforated lesions in the cecum and the ascending colon. We resected the lesions and closed them by simple suturing. Histologically nonspecific inflammatory infiltrations were noted in the neighborhood of the perforated ulcers, so called “punched out”. This was diagnosed as intestinal Behcet's disease because of the presence of abovedetailed clinical findings, iritis and positive HLAB-51. His postoperative recovery was uneventful without hyperalimentation therapy, and he was discharged on the 49th postoperative day. Surgical procedures are absolutely indicated in cases of the intestinal Behcet's disease with perforated lesions. Right hemicolectomy (resection of the ileum more than 1 meter from Bauhin's valve) and a hyperalimentation therapy are usual methods of treatment. However, in our case, only simple closure of the perforated lesions was performed and the patient's recovery was much better than the reported cases with conventional treatments
