Behçet病における小腸多発潰瘍

Multiple Ulcers of the Small Intestine with Behçet Disease

　1937年，H. Behçetが口腔粘膜・眼部および外陰部の再発性アフタ性潰瘍の3主徴を呈す疾患をBehçet病として発表して以来，今日では本疾患は多彩な臨床症状を呈する全身性疾患として認識されるようになってきたが，その症状の中でも，腸潰瘍は神経症状と並んで重篤な合併症として知られている¹⁾²⁾．

　著者らも，不全型のBehçet病患者において回腸の多発潰瘍をX線的及び内視鏡的に診断し，手術により治癒した症例を経験したので報告する．

　The patient, a woman 52 years old, had a chief complaint of abdominal pain along with stomatitis. She had been treated at the Department of Dermatology under a diagnosis of incomplete type of Behçet disease. She was referred then to our Department because of abdominal symptoms. X-ray and endoscopy here revealed multiple ulcers in the ileum. Surgical exploration was then done because they were considered intractable and penetration was suspected in some of them.

　The resected intestine showed 20 ulcers of various sizes over a segment from the terminal ileum to a point 90 cm oral from it. Histologic diagnosis was non-specific ulcer, but the majority of the ulcers were deep enough to be classified to Ul-IV, characterized further by hypertrophy and fibrinoid degeneration of the vascular walls not only in the floor of ulcers but in the submucosal layer of non-ulcerous areas as well. It could firmly be assumed that vascular changes be responsible for the origin of these ulcers.

　Literature of Behçet disease shows that among its protean symptoms intestinal ulcers tend to penetrate in the great majority of cases, constituting one of the most serious complications of this disease along with neurological disorders. The present case seems to warrant this fact. As compared with other non-specific ulcers, intestinal ulcer in Behçet disease is considered relatively specific.