An Operating Case Report of Probable Intestinal Behçet's Disease with Perforating Multiple Ulcers in the Right Colon

Tatsuhiko Yamanaka, Kazunari Okada, Mamoru Takahashi, Masahiko Takemoto, Taisou Tamura

Department of Surgery, Yanai National Hospital

We report surgical case of probable intestinal Behçet's disease with perforating multiple ulcers in the right colon. A 46-year-old woman visited our clinic complaining of abdominal pain and fever on March 25, 1994. She had recurrent aphthoid ulcers of the oral cavity and lips. An emergency operation was performed under a diagnosis of perforating peritonitis on day 5 after admission. There were multiple perforations in the cecum and ascending and transverse colon. Right extensive hemicolectomy was performed. Macroscopic examination of the resected colon revealed multiple discrete and punched-out ulcers and erosions. These ulcers were shaped like a spindle and perforations were seen in at least 15 points in the resected specimen. Microscopically there was a nonspecific inflammatory infiltrate in the neighborhood of the ulcers. These ulcers penetrated through the mucosa into the muscularis proria or serosa. According to the postoperative study of HLA types, HLA-B5 and HLA-Bw51 were detected and genital aphthoid ulcers also appeared postoperatively. Therefore intestinal Behçet's disease was suspected. A case like this was thought to be very uncommon because of the multiple perforations due to the characteristically shaped ulcers in the colon.

Key words
intestinal Behçet's disease, multiple ulcers, right colon

Reprint requests
Tatsuhiko Yamanaka Department of Surgery, Akane Foundation Tsuchiya General Hospital
3-30, Nakashimacho, Nakaku, Hiroshima, 730 JAPAN

Accepted
May 8, 1996

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