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Clinical Course of Intestinal Lesions in Patients with Intestinal Behçet's Disease and Simple Ulcer Mitsuo Iida 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University Keyword: 腸型Behçet病 , 単純性潰瘍 , X線像の経過 , 術後経過 , 吻合部再発 pp.287-302
Published Date 1992/3/25
DOI https://doi.org/10.11477/mf.1403106751
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 The clinical course of intestinal lesions was studied in 15 patients with intestinal Behçet's disease (12 of complete form and 3 of suspicious form) and 4 with simple ulcer. These patients were followed up for an average of 6.2 years (ranging from 1 year and 9 months to 15 years and 10 months) and repeatedly examined by radiography and/or endoscopy of the intestine. The resuits were summarized as follows.

 1) Of 12 non-surgical cases, 8 had typical intestinal lesions consisting of deep ulcers in the ileocecal region. In the remaining 4, radiography and endoscopy revealed atypical intestinal lesions. Two of them had irregularly-shaped or round-shaped ulcers in the ileum and colon, and 2 had only aphthoid ulcers in the colon.

 2) In 8cases with typical intestinal lesions, medical treatment using a combination of total parenteral nutrilion, salicylazosulfapyridine, and prednisolone, or using only one of these methods, was temporarily effective, but the intestinal lesions relapsed and recurred during the follow-up period.

 3) In 4 non-surgical cases with multiple ulcers of the terminal ileum, follow-up radiography revealed various changes of each ulcer. At each examination, it was found that an enlarged ulcer or a newly developed ulcer was often mixed with a healed ulcer.

 4) Four cases with atypical intestinal lesion showed good response to the medical treatments. None of the cases showed progression to typical intestinal lesion.

 5) Surgical resection was performed 16 times in 10 cases. Recurrence of intestinal ulcer was observed in 12 (75%) of the 16 surgical cases.

 6) Recurrence of the intestinal ulcer, commonly seen at the anastomotic site, occurred within 2 years after operation.

 7) Edematous change of the anastomotic site and aphthoid ulcers of the ileum were demonstrated as being characteristic radiographic findings at the early stage of recurrence.

 8) Recurrent ulcers were successfully treated by the medical therapies, but their effectiveness was temporary.

 9) There were no essential differences between the clinical courses of intestinal Behçet's disease and simple ulcer.

 10) These results suggest that, in this disease, to detect early lesions such as small ulcers and aphthoid ulcers, periodic follow-up examinations of the intestine should be carried out even in patients without digestive symptoms.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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