Xie Wen-Xing, Jiang Hai-Tao, Shi Guo-Qing, Yang Li-Na, Wang Hong
Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China.
World J Clin Cases. 2021 Apr 26;9(12):2854-2861. doi: 10.12998/wjcc.v9.i12.2854.
Behcet's disease (BD) is a chronic disease characterized by oral and vulvar ulcers as well as eye and skin damage and involves multiple systems. It presents as an alternating process of repeated attacks and remissions. Esophageal venous rupture and bleeding caused by BD is rarely reported at home and abroad. This paper reports a case of bleeding from oesophageal varices caused by BD, aiming to provide an additional dimension for considering the cause of bleeding from esophageal varices in the future.
A 38-year-old female patient was admitted due to a gradual increase in shortness of breath and chest tightness after the activity, and was admitted to our hospital for treatment. After admission, relevant examinations showed that the patient had multiple blood clots. Four days after admission, she suddenly experienced massive hematemesis. Emergency esophagogastroduodenoscopy revealed bleeding from esophageal and gastric varices. The patient had no history of viral hepatitis or drinking habits, and no history of special genetic diseases or congenital vascular diseases. There is no obvious abnormality in liver function. After reviewing the medical history, it was found that the patient had recurred oral ulcers since childhood, ulcers were visible in the perineum during menstruation, and there was an intermittent red nodular rash and uveitis. The current skin acupuncture reaction is positive, combined with the evaluation of the external hospital and our hospital, the main diagnosis is BD. She received methylprednisolone, cyclophosphamide, immunomodulation, acid suppression, gastric protection, and anticoagulation and anti-infection treatments, and was discharged from the hospital. During the 1-year follow-up period, the patient did not vomit blood again.
This case highlights bleeding from esophageal varices caused by BD, aiming to provide an additional dimension concerning the cause of bleeding from esophageal varices in the future.
白塞病（BD）是一种以口腔和外阴溃疡以及眼和皮肤损害为特征的慢性疾病，累及多个系统。它表现为反复发作和缓解的交替过程。BD引起的食管静脉破裂出血在国内外鲜有报道。本文报告1例BD所致食管静脉曲张出血的病例，旨在为今后考虑食管静脉曲张出血的原因提供新的视角。
一名38岁女性患者因活动后气短、胸闷逐渐加重入院治疗。入院后相关检查显示患者有多处血栓形成。入院4天后，患者突然大量呕血。急诊食管胃十二指肠镜检查显示食管和胃静脉曲张出血。患者无病毒性肝炎病史及饮酒习惯，无特殊遗传疾病或先天性血管疾病史。肝功能无明显异常。回顾病史发现，患者自幼反复出现口腔溃疡，月经期会阴部可见溃疡，并有间歇性红色结节性皮疹和葡萄膜炎。目前皮肤针刺反应阳性，结合外院及我院评估，主要诊断为BD。患者接受了甲泼尼龙、环磷酰胺、免疫调节、抑酸、胃保护、抗凝及抗感染治疗后出院。在1年的随访期内，患者未再呕血。
本病例突出了BD所致食管静脉曲张出血，旨在为今后食管静脉曲张出血的原因提供新的视角。
