腸型Behcet病の臨床

Clinical Studies on Intestinal Behcet Disease

　Behcet病は内科的にも外科的にもなお治療法の確立されていない難治な疾患である．特に腸型Behcet病と血管型Behcet病は外科的処置が必要となる場合が少なからずあり，死亡率も高いことが知られている．手術症例が少しずつ集積され，その病像に一定の傾向があることが次第に明らかになりつつあるが，なお個々の病変の詳細な臨床経過などについては今後の研究に待たねばならない点が多い．

　以下，限られた経験ではあるが，われわれが経験した症例を中心にアンケート調査，文献報告例を検討した結果について述べる．

　Analysis was made on 131 cases of intestinal Behcet disease which were collected by reviewing the reported cases in Japan, and by sending questionairs to major hospitals.

　Sex ratio (male/female) was 1.34/1.0.

　Age distribution at the time of operation was predominant at the 3rd decades.

　Among 131 cases of intestinal Behcet disease, 66 cases were classified into incomplete type Behcet desease.

　Aphtous stomatitis, genital ulcer and arthritis are commonly accompanied with intestinal Behcet disease.

　In the majority of the cases (105 cases: 80.2%), the lesions were found in the intestine between terminal ileum and cecum.

　Seventy cases were operated as an emergency because of perforation, bleeding etc.

　Analysis was made on 127 cases in which the location of ulcers was described in detail, revealing 50 perforations, including 27 cases of multiple perforations.

　Thirty one cases were reoperated because of reperforation, or recurrence of ulcer at the site of anastomosis.

　As for operative procedures, the reoperation rate of ileocecal resection was 30.2% and that of right hemicolectomy was 20.7%