Analysis of the Efficacy of Medical Treatment and the Cumulative Operation Rates of Behcet's Colitis According to the Colonoscopic Classification

Kim, Joo Sung; Moon, Hae; Choi, Il Ju; Park, Min Jung; Kim, You Sun; Lee, Jin Hyuk; Jung, Hyun Chae; Song, In Sung; Kim, Chung Yong

Abstract

BACKGROUND/AIMS: The lesions of Behcet's colitis showed aphthoid or punched-out ulceration, but the macroscopic types of lesions have not been defined. The aim of this study was to predict the clinical outcome of patients with Behcets colitis according to colonoscopic findings. METHODS: We retrospectively reviewed the medical records and colonoscopic photographs of 50 patients with Behcet's colitis. Colonoscopic findings were categorized according to three types: volcano-, geographic- and aphthous-type. The efficacy of medical treatment was assessed by follow-up colonoscopy or double-contrast barium enema 4 to 8 weeks after treatment and recurrence of the lesions was evaluated during the follow-up period. Cumulative operation rates were obtained by the Kaplan-Meier method.
RESULTS
Macroscopic types of colonic ulcers revealed 25 out of 50 (50%) patients with volcano-type, 11 (22%) with geographic-type, and 14 (28%) with aphthous-type lesions. Complete remission rates by medical treatment and operation rates in volcano-type ulcerations were 6 of 25 (24%) and 13 of 25 (52%), geographic-type 8 of 11 (73%) and 1 of ll (9%), and aphthous-type 9 of 14 (64%) and 2 of 14 (14%), respectively. The recurrence rate in volcano-type ulcerations was 9 of 19 (47%), geographic-type 1 of 9 (11%) and aphthous-type 1 of 11 (9%),
CONCLUSIONS
Volcano-type ulcerations in Behcets colitis showed less favorable response to medical treatment and more episodes of operation and recurrence than geographic- and aphthous-type ulcerations.