Surgical treatment of intestinal Behçet's disease

From 1983 to 1994, we diagnosed 37 cases of intestinal Behçet's disease and performed operations on 26 patients at the Surgical Department of Yonsei University Medical Center. Sixty percent of patients were in their teens and twenties (mean age: 36.4 years). Preoperative diagnosis of Behçet's disease was correctly made in only 8 cases (30%). In 32 cases (86.5%), the lesion was localized regardless of the number of ulcers. A solitary ulcer was observed in 22 cases (60%), while multiple ulcers were present in 15 cases. A recurrence after the initial operation was observed in 12 patients (46.1%) and reoperation was performed 19 times. Fifty percent of recurrence developed within 2 years after each operation. The type of operation, the location of lesion and the number of ulcers did not appear to be related to the recurrence. As a preoperative diagnosis is difficult and the recurrence rate is high, post- operative periodic follow-up with radiography and endoscopy are strongly recommended. At the time of operation, the entire bowel should be examined and bowel resection should include a generous normal resection margin as well as skip lesions.