Behçet’s disease and the alimentary tract

Parkin, JamesColes; Wight, D. G. D.

doi:10.1136/pgmj.51.594.260

Cited by 27 publications

(23 citation statements)

References 20 publications

(21 reference statements)

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“…The ulcers may be localized or diffuse and can involve any part of the gastrointestinal tract [8,9,18], although we did not experience the diffuse type in the colon. While Smith et al [6] reported a high incidence of rectal involvement in colitis in Beh~et's disease similar to ulcerative colitis, Behget's colitis seems to involve predominantly the ileocecal area and proximal ascending colon according to other studies, including the Japanese series with a literature review of 136 cases [4,8,16].…”

Section: Discussionmentioning

confidence: 77%

“…Microscopically, fibrinoid necrosis and perivascular lymphocytic infiltration have been reported in association with nonspecific inflammation [2,4,8,9]. Baba et al [4] demonstrated a relatively avascular area around the ulcer by microangiography, suggesting the possibility of a secondary phenomenon of a vascular etiology.…”

Section: Discussionmentioning

confidence: 99%

“…According to the case reports and literature reviews of reported cases since the first description by Bechguard in 1940 [15], the hallmark of colitis in Beh~et's disease is an ulceration similar to either ulcerative colitis with involvement of the rectosigmoid colon [6,[11][12][13] or Crohn' s disease in a case of discrete ulcers, skip lesions, and rectal sparing [2,4,9,16]. These similar radiological findings and a significant overlap in the clinical features between Beh~et's disease and other common inflammatory bowel diseases caused controversy as to whether these cases represented true involvement of the colon by Beh~et's disease, coincidental inflammatory bowel disease and Beh~et's disease, or merely autoimmune phenomena associated with inflammatory bowel disease.…”

Section: Discussionmentioning

confidence: 99%

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Colitis in Behçet's disease: Characteristics on double-contrast barium enema examination in 20 patients

et al. 1994

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We performed a retrospective review of double-contrast barium enema examinations of 20 patients with clinically proven Behçet's colitis. Main lesion was ovoid or geographic ulcers with a mean diameter of 2.7 cm. The number of ulcers was single in 15 cases and multiple in five. On six resected specimens, ulcers involved submucosa in three, muscle layer in one, and serosa in two cases with an undermining tendency and transmural inflammation. Aphthous ulcers were present in three cases. Neither perforation nor fistula was demonstrated. In all 20 patients, the ulcer was localized in the ileocecal area, with extension to the ascending colon in seven. Skip lesions were observed in the transverse colon and descending colon in three cases. Destruction of surrounding mucosa resulted in cecal contraction in 19 cases, widening of the ileocecal valve in 19, and fold thickening in the terminal ileum in 12. Six cases (30%) manifested as ileocecal mass accompanied by ulcer, fold thickening, and adjacent mucosal deformity. The appendix was visualized in only three (20%) of the 15 patients with no history of appendectomy. On follow-up study of 15 cases, the ulcers disappeared or decreased in size in 13 cases (86%) and the mucosal deformity was not improved in all cases. On the basis of our results, we believe that the characteristic findings of colitis in Behçet's disease in barium enema examination are ovoid or geographic, relatively large, and deep ulcerations with persistent surrounding deformity which tend to localize in the ileocecal area.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Colitis in Behçet's disease: Characteristics on double-contrast barium enema examination in 20 patients

et al. 1994

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“…Esophageal lesions located in the middle esophagus are the most common, although diffuse esophagitis and stenosis has also been reported (6). Lesions have demonstrated varying severity, with spontaneous resolution under conservative observation on the one hand (7), and perforation and tracheo-esophageal fistula requiring surgical treatment on the other (4,8,9). Almost all previously reported cases underwent gastrointestinal endoscopy for investigation of severe upper gastrointestinal symptoms.Bottomley et al maintained that routine endoscopy is of no value in otherwise asymptomatic patients, as their 8 patients who had received gastrointestinal endoscopy without severe dysphagia or pain had displayed no esophageal involvement (10).…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment with Corticosteroid in a Case of Behcet's Syndrome with Multiple Esophageal Ulcerations

Yasuo¹,

Miyabayashi²,

Okano³

et al. 2003

Intern. Med.

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A 59-year-old womanwas diagnosed with incomplete type Beh^et's syndrome in 1994. The patient was hospitalized with pharyngitis and fever in August 2000, and was treated using non-steroidal anti-inflammatory drugs (NSAIDs). Symptoms improved and she was discharged. After only 3 weeks, she reported swallowing disturbance due to retrosternal pain. Esophagoscopy revealed multiple shallow oval ulcerations in the middle esophagus. Colonoscopy revealed aphthous lesions in the rectum. Prednisolone (0.5 mg/kg) was initiated for treatment of esophageal involvement. Symptoms gradually improved and subsequent esophagoscopy revealed complete healing of esophageal ulcerations. (Internal Medicine 42: 696-699, 2003)

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“…1 Intestinal Behçet's disease, which is one of the entities of Behçet's disease, is often due to nonspecific ulcers, especially in the distal ileum and cecum, but rarely in the esophagus. [2][3][4][5] Esophageal involvement in Behçet's disease is very uncommon and to date less than 50 cases have been reported. [5][6][7][8][9][10] This report describes esophagobronchial fistula in a patient associated with intestinal Behçet's disease.…”

Section: Introductionmentioning

confidence: 99%

Esophagobronchial Fistula in a Patient with Behçet’s Disease: Report of a Case

et al. 2005

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Esophageal involvement in Behçet's disease is generally considered to be very uncommon. So far, six cases of esophageal ulcers associated with perforation, penetration, or fistula in Behçet's disease have been described in the English literature. This report describes esophagobronchial fistula in a patient with intestinal Behçet's disease. A 62-year-old man was transferred to our hospital for peritonitis due to a small intestinal perforation after an appendectomy. At the age of 14 years he had had recurrent oral ulcers. Ulcerations of the ileum and epididymitis were found, and a pathological examination revealed nonspecific inflammation. Furthermore, an esophageal ulcer with esophagobronchial fistula was diagnosed. The fistula required not only endoscopic treatment but also surgical intervention. The patient's clinical features were consistent with the active phase of intestinal Behçet's disease. The symptoms gradually resolved without any treatment. Four years after remission, however, the symptoms recurred with gastrointestinal hemorrhage and polyarthritis. In the ileocolic region, punch-out ulcerations were noted. The clinical history and features led to a diagnosis of Behçet's disease associated with recurrent gastrointestinal ulcerations. Steroid therapy (prednisolone, 20 mg daily) was started, and led to a rapid resolution of the symptoms. The patient is now being followed up as an outpatient while receiving prednisolone (10 mg per day), without complaint of any gastrointestinal symptoms.

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Behçet’s disease and the alimentary tract

Cited by 27 publications

References 20 publications

Colitis in Behçet's disease: Characteristics on double-contrast barium enema examination in 20 patients

Colitis in Behçet's disease: Characteristics on double-contrast barium enema examination in 20 patients

Successful Treatment with Corticosteroid in a Case of Behcet's Syndrome with Multiple Esophageal Ulcerations

Esophagobronchial Fistula in a Patient with Behçet’s Disease: Report of a Case

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