Results of Surgical Treatment in Intestinal Behcet's Disease

Kim, Ki Hong; Park, Kyu Joo; Yang, Han Kwang; Park, Jae Gahb; Kim, Sang Joon

Abstract

Behcet's disease, originally defined by recurrent oral and genital ulcers and uveitis, is regarded as a multisystemic disorder that may involve various organs. Intestinal involvement in Behcet's disease is characterized by ulcers which tend to perforate or penetrate the intestinal wall. Thus, many patients with this disease require surgical intervention. This study was performed to analyze the results of the surgical treatment in patients with intestinal Behcet's disease. We have performed a retrospective analysis of 30 patients with pathologically defined intestinal Behcet's disease who had undergone operations at the Department of Surgery, Seoul National University Hospital between 1984 and 1996. The ulcers were most frequently located in the ileocecal area(79%) and 46% of the patients had multiple ulcers. The mean age at the time of first operation was 34 years(range: 14-58) and the mean interval from onset of symptoms to operation was 22 months(range: 0.3-96). The most common indications which led to operation were intractable pain (37%), followed by suspicion of malignancy(27%), obstruction(13%), perforation(10%) and bleeding(10%). Surgical treatment consisted of resection of the involved area in all cases except one patient who had undergone primary closure of the perforated ulcer. After mean follow-up period of 55 months(range: 1-120) after the primary operation, recurrence was observed in 17 cases(57%). The cumulative recurrence rate was 25% at 1 year, 37.9% at 3 years, and 61.2% at 5 years. Our results indicate that intestinal Behcet's disease is associated with high incidence of postoperative recurrence.