Hizawa Kazuoki, Kai Hidenobu, Hasegawa Hirofumi, Nakahara Tsukane, Akagi Kimihiro, Iwai Keiichiro, Tamiya Sadafumi, Matsumoto Takayuki
Department of Internal Medicine, Kyushu Central Hospital, Fukuoka, Japan.
Surg Today. 2002;32(2):167-9. doi: 10.1007/s005950200013.
Intestinal ulcers in Behçet disease tend to cause perforation, and postoperative recurrence is common with a high mortality rate. The optimal therapeutic strategy has yet to be elucidated, particularly in cases of diffuse intestinal involvement. We herein present a case of diffuse intestinal Behçet disease with ileal perforation. A 57-year-old Japanese woman was referred to our institution with complaints of intractable oral ulcers and abdominal pain. The patient underwent an emergency laparotomy for perforated peritonitis in spite of the intravenous administration of prednisolone (1.5 mg/kg) under total parenteral nutrition. Macroscopically, an inflamed ileum measuring 1.6 m in length was resected, including a 1-cm perforated ulceration. Innumerable small and deep ulcers were also observed, consisting of nonspecific inflammation. The patient has been free from any recurrence of intestinal ulcers while being treated with prednisolone, colchicine, and a low-residue diet for 1.5 years.
白塞病中的肠道溃疡容易导致穿孔，术后复发很常见，死亡率很高。最佳治疗策略尚未阐明，尤其是在弥漫性肠道受累的病例中。我们在此报告一例伴有回肠穿孔的弥漫性肠道白塞病病例。一名57岁的日本女性因顽固性口腔溃疡和腹痛被转诊至我院。尽管在全胃肠外营养支持下静脉注射了泼尼松龙（1.5mg/kg），患者仍因穿孔性腹膜炎接受了急诊剖腹手术。肉眼可见，切除了一段长1.6米的发炎回肠，其中包括一个1厘米的穿孔性溃疡。还观察到无数小而深的溃疡，由非特异性炎症组成。患者在接受泼尼松龙、秋水仙碱治疗并采用低渣饮食1.5年后，未出现肠道溃疡复发。
