Masugi J, Matsui T, Fujimori T, Maeda S
Department of Medicine, Kobe University, School of Medicine, Japan.
Am J Gastroenterol. 1994 May;89(5):778-80.
We experienced a rare case of intestinal Behçet's disease simulating Crohn's colitis. A 70-yr-old female presented oral and genital ulcers, erythema nodosum, arthralgias, and abdominal pain. Regardless of our efforts, she died of septic shock. Autopsy showed punched-out ulcers in the terminal ileum and multiple longitudinal ulcers with inflammatory polyposis spreading from the ascending to the descending colon. The differential diagnosis of intestinal Behçet's disease versus Crohn's disease was difficult. However, microscopic findings showed nonspecific ulceration, and no evidence of Crohn's disease could be found. Clinically, the patient met the criteria of Behçet's disease, and punched-out ulcers in the ileocecal region, which is characteristic of intestinal Behçet's disease, confirmed the diagnosis of Behçet's colitis. Although rarely encountered, multiple longitudinal ulcers can involve all of the colon in Behçet's disease, like Crohn's disease.
我们遇到了一例罕见的肠道白塞病，临床表现酷似克罗恩病。一名70岁女性出现口腔和生殖器溃疡、结节性红斑、关节痛及腹痛。尽管我们全力救治，她仍死于感染性休克。尸检发现回肠末端有深凿样溃疡，以及多个纵向溃疡，并伴有炎性息肉，从升结肠蔓延至降结肠。肠道白塞病与克罗恩病的鉴别诊断颇具难度。然而，显微镜检查结果显示为非特异性溃疡，未发现克罗恩病的证据。临床上，该患者符合白塞病的诊断标准，且回盲部出现的深凿样溃疡是肠道白塞病的特征性表现，从而确诊为白塞氏结肠炎。虽然较为罕见，但白塞病中的多个纵向溃疡可累及整个结肠，这与克罗恩病类似。
