Intestinal Behcetの1症例

A Case Report of Intestinal Behcet's Disease

　完全型のintestinal Behcetの1例を報告し，主に切除腸管の病理学的所見を提示する．

症例

　患者：N. M.　No.20-53-73.　41歳　男

　主訴：二腹痛，発熱

　現病歴：1967年関節痛にて発症し，続いて眼症状，口内アフタ，陰部潰瘍の出没している完全型Behcet病である．1976年11月14日突然腹部全体に持続的疼痛が出現，漸次増強し，発熱，便秘，悪心嘔吐を伴ってきたため16日当内科に緊急入院した．1976年7月初診以降ステロイド剤の服用はない．

　A 41-year-old man had been suffered from the complete type of Behcet's disease since ten years ago. On admission, he was acutely ill and complained of abdominal pain as well as high fever. Physical examination and abdominal plain films revealed intestinal obstruction as a result of acute peritonitis. Barium enema and superior mesentric angiography suggested the ulcerative lesions of the terminal ileum. Emergency ileocecal resection were performed.

　Macroscopically, there were multiple punched-out ulcerations in the terminal ileum. The main lesions were round or oval in shape, found at the antimesenteric border and scattered at regular intervals. Other crevice-like small ulcers were also noted in the terminal ileum. Microscopically, remnants of the Peyer's patches were found at the margin of the main lesions. Fissuring and accumulation of the lymphocytes were demonstrated in the granulation tissue at the basis of crevice-like small ulcers.

　We suggested that these lesions appeared in the Peyer's patches as well as in the solitary lymphnodes of the mucosa.