Colonoscopic Findings in Intestinal Behçet's Disease

Abstract

The aims of this study were to investigate the clinical and colonoscopic characteristics of patients with intestinal Behçet's disease and to compare the findings of typical and atypical intestinal Behçet's disease. Ninety-four patients diagnosed as having intestinal Behçet's disease were included. Of these, we considered 42 patients as having complete or incomplete type; these fulfilled the international criteria as "typical," and the other 52 patients were classified as having "atypical" intestinal Behçet's disease. Abdominal pain was the most common symptom (92%), followed by diarrhea and gastrointestinal bleeding. All of the 22 patients with a history of surgery had ulcers at the anastomotic site. Most of the patients, who had never been operated on, had lesions in the ileocecal area (96%). Sixty-three patients (67%) had a single ulcer. Many (76%) of the ulcers were larger than 1 cm, and the mean size of the ulcers was 2.9 cm. Most (99%) of the ulcers were round/oval or geographic in shape. Usually ulcers were deep (62%), and their margins discrete (80%). There was no difference in the endoscopic findings of typical and atypical intestinal Behçet's disease. Typical colonoscopic findings in intestinal Behçet's disease were single or a few deep ulcers with discrete margins in the ileocecal area or anastomotic site. Endoscopic characteristics of patients with intestinal involvement in the case of "suspect" or "possible" type of Behçet's disease that lack the systemic manifestations of Behçet's disease were in accord with those in "complete" or "incomplete" types of Behçet's disease, who fulfill the International Study Group for Behçet's Disease criteria.

Development and Validation of Novel Diagnostic Criteria for Intestinal Behçet's Disease in Korean Patients With Ileocolonic Ulcers

“…Th e ileocolonic ulcerations were divided into " typical " and " atypical " ulcerations for intestinal BD on the basis of colonoscopic fi ndings ( Figure 1 ). Patients with < 5 ulcers that were oval in shape, deep, with discrete borders, and were located in the ileocecal area were classifi ed as having " typical " ulcers (9) . Ulcerations that did not fulfi ll all of the characteristics were regarded as atypical.…”

“…In addition, because of its scarcity and the lack of clinical evidence, no specifi c diagnostic criteria have been developed for intestinal BD. Th us, the diagnosis of intestinal BD has been based primarily on a combination of the clinical criteria for the diagnosis of systemic BD and the identifi cation of intestinal ulcerations by endoscopy or radiographic imaging (6,8,9) . However, not all patients with intestinal BD satisfy the systemic BD criteria at the time of colonoscopic evaluation and systemic manifestations may develop sequentially aft er several years, resulting in diagnosis delay (9,10) .…”

Anti-Alpha-Enolase Antibody as a Serologic Marker and Its Correlation with Disease Severity in Intestinal Behçet’s Disease

“…In addition to the Japanese criteria, we used the criteria of the International Study Group for Behçet's disease (ISGBD) from 1990, which require the presence of oral ulceration plus any two of the following: genital ulcerations, typical eye lesions, typical skin lesions, and positive results to a pathergy test [15]. Intestinal BD was diagnosed using a combination of clinical, endoscopic [16], radiologic [17], and pathologic findings. All patients were followed for at least 1 year after diagnosis of intestinal BD.…”

“…Various parameters, such as clinical and laboratory findings, colonoscopic findings, and treatment modality, were retrospectively collected from medical records. Endoscopic findings involving the number, size, location, distribution, depth, shape, and margin of ulcers were analyzed [16]. The distribution pattern of intestinal lesions was classified as localized single, localized multiple, or multi-segmental.…”

Endoscopic findings of intestinal Behçet’s disease complicated with toxic megacolon

“…2), but unfortunately she died of disseminated intravascular coagulation after surgery. In Behc¸et's disease, while involvement of the gastrointestinal tract is relatively uncommon [1], the rate of perforation is relatively high [2,3]. However, complication of Behc¸et's disease with a toxic megacolon is extremely rare [4,5].…”