Intestinal Behcetの1例

A Case Report of Intestinal Bechcet Disease

　Behcet病は口腔粘膜の再発性アフタ性潰瘍，皮膚症状，眼症状，外陰部潰瘍を主症状とする全身病である．わが国で戦後とくに増加し¹⁾，予後の面から神経症状，消化器症状などの副症状が注目されてきた²⁾³⁾．最近，諸症状の原因として臓器血管の異常が重要視されている⁴⁾⁵⁾が，Behcet病の病因についてはまだ不明で，治療法も確立されてはいない¹⁾⁶⁾．

　著者らは，回腸末端部の多発性潰瘍から大量出血を生じたBehcet病の1例を経験し，血管造影にて潰瘍部に一致して特異な造影所見を認めた．また本例では新鮮血輸血およびγ一グロブリン投与後，諸症状の著明な改善を認めたので，若干の考察を加えて報告する．

　A 50-year-old male was admitted on July 31, 1976. He had recurrent fever, aphthous stomatitis, skin eruption, ulcer of the penis and pseudobulbar palsy during the last 2 years.

　Nonspecific inflammation was suspected, but various antibiotics were ineffective. He developed progressive abdominal distention and massive melena occurred abruptly on the 10th hospital day. Superior mesenteric angiography on the next day revealed a pooling and/ or extravasation and dilatation of the vessels supplying the terminal ileum. These findings indicated acute inflammatory process, and coincided with multiple pounched-out ulcers observed by barium enema and endoscopical examination. Transfusion of total of 5,700 ml of fresh whole blood and administration of 5gm of γ-globulin were immediately followed by remission lasting for over the next 8 months. The ileocecoectomy was performed during the remission and it disclosed small ten ulcers of various stages mainly at the antimesenteric side of the terminal ileum. Histological examination revealed nonspecific ulcers, some of which penetrated into the serosa. These findings were consistent with those of the cases of intestinal Behcet reported in the literature.