Successful treatment of extensive intestinal perforations from Behcet's disease involving the whole gut: A case report
Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.International Journal of Rheumatic Diseases (Impact Factor: 1.47). 10/2013; 16(5):595-8. DOI: 10.1111/1756-185X.12168
Intestinal perforation resulting from Behcet's disease has been previously well recognized. To date, fewer than 100 cases of this nature have been reported. Nearly the entire digestive system can be involved, including esophageal, gastric, duodenal, ileum, colon and anal tissues. Most of the reported perforations are single or assembled. Herein, an 8-year-old Chinese girl who developed Behcet's disease with extensive intestinal perforations throughout the gut was successfully treated and is presented. The diagnosis of Behcet's disease was established based on the typical presentations of recurrent oral aphthous ulcers, genital ulcers, typical eye lesions and a positive skin prick test. The extensive intestinal perforations were confirmed by laparotomy. Taking her developmental requirements into consideration, a simple perforation repair was carried out, followed by routine administration of immunosuppressive treatment, and the symptoms were temporarily relieved. Unfortunately, another ileocecal perforation occurred after 1.5 years, and an ileocolectomy was carried out. After the procedure, the girl recovered well. Clinicians should be aware of Behcet's disease as a unique source of intestinal perforation. Although it is encountered rarely in clinical settings, this condition should be considered in each case of intestinal perforation. An ileocolectomy was the necessary choice for radical treatment, even in the case of a pediatric patient.