A CASE OF INTESTINAL BEHÇET DISEASE WITH MULTIPLE SMALL INTESTINAL ULCER

We experienced a patient emergently operated on for generalized peritonitis, whom dozens of uclers in the entire small intestine and intestinal perforation were detected. A 67-year-old man receiving an antibiotic for common cold and abdominal distention for several days was seen at another hospital because of worsened abdominal distention and abdominal pain. The patient was transferred to the emergency center of our hospital with a diagnosis of intestinal obstruction. CT examination confirmed perforation of the intestine. On laparotomy sporadic ulcers were found in the entire small intestine, especially in the terminal ileum, at where perforation existed. Intestinal Behcet disease with small intestinal ulcers was susepcted. Excision of the ileocecal region was performed and sporadic ulcers were sutured and closed. Immediately after the operation the same type of ulcers in the oral cavity as those in the small intestine and folliculitis like eruptions in the anterior thoracic region were found, but they disappeared within several days. No eye symptoms nor external pudental ulcers were confirmed. The definite diagnosis of intestinal Behcet disease could not be made, but it was strongly suspected, because the patient showed positive response to HLA-B51. The patient is strictly followed on an ambulant basis. It is rare for intestinal Behcet disease that ulcers appear in the entire small intestine. Some notes based on the relevant literature are also presented.