The Risk of Ileocolonic Perforation in Patients with Behet's Disease: Report of Three Cases and Review of the Literature
2014
Introduction/Purpose: Intestinal Behcet’s disease may cause serious complications. Massive hemorrhage,
fistulisation and intestinal perforation are encountered complications in approximately 50% of patients suffering from
intestinal Behcet’s disease. Currently, there is not enough data inquiring iatrogenic ileocolonic perforation during
colonoscopy in patients with intestinal Behcet’s disease; therefore we aimed to study intestinal Behcet’s disease
patients who suffered perforation during or after colonoscopy.
Methods: A total of 2615 colonoscopic examinations were performed between May 2002 and December 2007.
Of these 2615 patients, main indication for colonoscopy was intestinal Behcet’s disease in 135 patients.
Results: In total 135 patients with Behcet’s patients were assessed with colonoscopy due to presumed
ileocolonic involvement. 8 out of 135 (5.9%) patients had ileal and colonic ulcers. 3 patients (2.22%) had iatrogenic
perforation, 2 of whom had profound ulcers in proximal colon and ileum. The third case had ulcers in sigmoid colon,
descending and transverse colon segments. All these 3 patients had undergone surgical intervention including ileal
resection and right hemicolectomy.
Discussion: Colonoscopic examination is commonly used in Behcet’s disease not only for diagnostic purposes
but also for surveillance of intestinal involvement in Behcet’s disease. Volcano-shaped ulcers are specially inclined
to perforate. Both clinicians and endoscopists should be alert against barotrauma applied during colonoscopy may
cause perforation. Also patients should be followed-up necessarily and in case of abdominal pain after colonoscopic
examination, colonic perforation should always be kept in mind.f
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