Behçet頸動脈瘤の1症例

A Case of Carotid Aneurysm in Behçet's Disease

I．はじめに

　Behçet病は口腔粘膜，眼，皮膚，外陰部症状を主症状とし，重要臓器に広汎かつ多彩な副症状を呈する慢性遷延性の全身的な疾患であり，またアフタ性口内炎がほとんど必発であることから，耳鼻咽喉科領域においても稀ならず遭遇する疾患である。本症のうち血管系の症状を主病像とする血管型Behçet病（Angio-Behçet）は患者の予後を重篤化させる病型として注目される。筆者らは眼症状を欠く不全型Behçet病で，総頸動脈瘤を合併し手術的にこれを切除し得た症例を経験したのでここに報告する。

　A 49-year-old man, who had never lived outside of japan, had recurrent oral and genital ulceration and erythema nodosum of 5 years' duration. In June 1980, he first attended hospital with cerebral venous thrombosis and a year later, he complained of sudden onset of a severely painful swelling in his left upper cervical region. Examination revealed a pulsatile tender firm mass, 43×50mm in diameter, and carotid bruits were also audible. Angiography showed a large aneurysm of the left common carotid artery at the level of bifurcation. Because of increasing size of this mass, occlusion of left carotid with a Selverstone cramp was firstly attempted and finally the aneurysm was successfully extirpated.

　In the present paper, the problems accompanying with aneurysm of Behçet's disease were also discussed.