⑨Intestinal Behçetの1例

Intestinal Behçet with Multiple Ileal Ulcers; A case report

　完全型Behçet症候群と診断された女性の経過中に，右下腹部痛が出現し，X線検査にて回腸末端部に多発潰瘍を認め，手術を施行した，いわゆるIntestinal Behçetの症例を呈示するとともに，診断的立場から若干の考察を加えた．

　A 38-year-old female had been treated as Behçet syndrome having such typical symptoms as stomatitis, genital ulceration, uveitis and erythema rodosum. Six years later, she had small bowel follow-through study because of abdominal pain, and it revealed three large, irregular-shaped and undermining ulcers at the terminal ileum.

　This patient was diagnosed as complete type of Behçet syndrome, therefore, this type of ulcers in this case was thought to be typical in intestinal Behçet. General characteristics of the ileal ulcers in intestinal Behçet were discussed. Abdominal symptoms are, in the frequent order, lower abdominal pain, diarrhea and ileo-cecal tumor. The most frequently affected site is an ileo-cecal region. The ulcers are usually multiple, and tend to undermine macroscopically. Histology of the ulcers reveals only non-specific inflammatory changes and shows perforative or penetrative findings at the muscular layer of the intestine. The base of the ulcer shows rich in vascularity and round cell infiltration. As an unusal morphological feature in this case, a fistula-like formation within the marginal wall of the ulcer was found. Further observation is needed to determine whether this fistula-like structure is characteristic in intestinal Behçet or not.