A Case of Intestinal Behçet's Disease Treated only by Simple Closure of Perforated Lesions in the Cecum and the Ascending Colon

Masahiro Hirose, Tomomi Yokota, Atsurou Sugita¹⁾ , Shinichi Murao¹⁾ and Kanji Kawachi²⁾

Department of Surgery, Municipal Hospital of Nomura
¹⁾ Department of Pathology I, Ehime University School of Medicine
²⁾ Department of Surgery II, Ehime University School of Medicine

We report a case of intestinal Behet'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 Behet's disease because of the presence of above-detailed 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 Behet'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.

Key words
intestinal Behet's disease, surgical indication for intestinal Behet's disease, minimal surgical procedure

Reprint requests
Masahiro Hirose Department of Surgery, Kousei General Hospital 3-3-28 Minami, Mihara-shi, 723-8686 JAPAN

Accepted
January 27, 1999

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