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Colonic perforation in Behcet's syndrome.

Catherine-M Dowling¹, Arnold-Dk Hill, Carmel Malone

¹Department of Surgery, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland. kathdowling@hotmail.com

World Journal of Gastroenterology

|November 26, 2008

Summary

Behcet's syndrome, a rare condition, can present with severe gastrointestinal issues. This case highlights colon perforations as an unusual initial symptom of Behcet's syndrome in a young patient.

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Area of Science:

Gastroenterology
Rheumatology
Internal Medicine

Background:

Behcet's syndrome (BS) is a multisystemic vasculitis with variable clinical manifestations.
Gastrointestinal involvement in BS can lead to serious complications, including perforation.
Early diagnosis and management are crucial for improving patient outcomes.

Observation:

A 17-year-old male presented with headache, leading to a differential diagnosis including Behcet's syndrome.
The patient developed an acute abdomen, with radiographic evidence of pneumoperitoneum (air under the diaphragm).
Laparotomy confirmed multiple colonic perforations as the cause of the acute abdomen.

Findings:

This case represents an unusual presentation of Behcet's syndrome, with colonic perforations occurring at the initial disease manifestation.
The findings underscore the importance of considering Behcet's syndrome in the differential diagnosis of unexplained gastrointestinal emergencies, especially in young individuals.
A review of the literature identified this as a rare, yet significant, complication.

Implications:

Highlights the potential for gastrointestinal perforation as a primary presenting sign of Behcet's syndrome.
Emphasizes the need for a high index of suspicion for BS in patients with unexplained abdominal emergencies.
Suggests that prompt surgical and medical management can be life-saving in such critical presentations.