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02 May 2015 : Case report  Turkey

Colon Perforation and Budd-Chiari Syndrome in Behçet’s Disease

Unusual clinical course

Yılmaz BaşA, Güven GüneyB, Pınar Uzbay, Ethem ZobacıD, Selin ArdalıE, Ayşegül Taylan ÖzkanF

DOI: 10.12659/AJCR.892757

Am J Case Rep 2015; 16:262-267

Abstract

BACKGROUND: Behçet’s disease is a chronic inflammatory disease involving multiple systems, with vasculitis being the most important pathological feature. Multiple colon perforations are thought to be secondary to vasculitis and they occur in patients with ulcers. These may be encountered within the entire colon but most commonly in the ileocecal region. Intestinal perforation and Budd-Chiari syndrome are infrequent in Behçet’s disease, and are associated with high mortality and morbidity. Budd-Chiari syndrome results from occlusion of either hepatic veins or adjacent inferior vena cava, or both.

CASE REPORT: We report a patient with Behçet’s disease having multiple perforations in the transverse colon, descending colon, and sigmoid colon. The patient also had Budd-Chiari syndrome due to inferior vena cava thrombosis extending into the right and middle hepatic vein. Our observations are presented with a review of the literature.

CONCLUSIONS: In Behçet’s disease, treatment of colon perforation necessitates urgent surgery, whereas management of Budd-Chiari syndrome is directed towards the underlying cause. Behçet’s disease, as a chronic multisystemic disease with various forms of vasculitis, is resistant to medical and surgical treatment. Prognosis is worse in Behçet’s disease with colon perforation than that in Budd-Chiari syndrome alone.

Keywords: Budd-Chiari Syndrome - diagnosis, Behcet Syndrome - diagnosis, Colectomy, Colonic Diseases - surgery, Colonoscopy, Diagnosis, Differential, Intestinal Perforation - surgery, Rupture, Spontaneous, Tomography, X-Ray Computed

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923