Gastrointestinal Behҫet's disease mimicking appendicitis.

Area of Science:

• Gastroenterology
• Rheumatology
• Internal Medicine

Background:

• Behçet's disease is a rare multisystem inflammatory disorder.
• Abdominal pain is a common manifestation, often mimicking surgical emergencies like appendicitis.
• Immunosuppressive therapy in Behçet's disease can alter disease presentation.

Purpose of the Study:

• To highlight the diagnostic challenge of differentiating Behçet's disease flare from appendicitis.
• To emphasize the utility of colonoscopy in diagnosing gastrointestinal Behçet's disease.
• To illustrate the successful management of Behçet's disease presenting as appendicitis.

Main Methods:

• Case report of a patient with a history of Behçet's disease presenting with abdominal pain.
• Initial diagnostic workup included CT scan, suggesting appendicitis.
• Subsequent diagnostic evaluation involved colonoscopy to assess for gastrointestinal pathology.

Main Results:

• CT scan findings were consistent with appendicitis.
• Colonoscopy revealed aphthous ulcers, a large cecal ulcer, and appendiceal orifice inflammation, indicative of ileocecal Behçet's disease.
• Treatment with systemic glucocorticoids led to complete symptom resolution.

Conclusions:

• Behçet's disease can present with symptoms mimicking acute appendicitis.
• Colonoscopy is crucial for accurate diagnosis in such cases, potentially avoiding unnecessary surgery.
• Prompt recognition and appropriate immunosuppressive therapy (glucocorticoids) are vital for managing gastrointestinal Behçet's disease flares.