Aneurysm, False ; surgery ; Aorta ; surgery ; Behcet Syndrome ; surgery ; Fatal Outcome ; Humans ; Male ; Young Adult

Behcet's disease (BD) is a chronic, relapsing, multisystem disorder, characterized by recurrent oral ulcer, genital ulcers, eye lesion, and skin lesion. The underlying pathology is nonspecific vasculitis of all vessel sizes, and severe vasculitis can result in fistula formation of neighboring tissues due to a necrotic process. Herein, eleven cases of BD combined with fistula are presented. In the present study, various types of fistula were associated; enterocutaneous fistula in six patients, and rectovaginal fistula in two. The other three patients showed aortoduodenal fistula, urethrovaginal fistula and urethrocutaneous fistula. They were treated with a corrective operation, but the prognoses were poor due to frequent relapses.
Humans ; Fistula/*etiology/surgery ; Female ; Behcet Syndrome/*complications/pathology ; Adult ; Adolescent

From 1983 to 1994, we diagnosed 37 cases of intestinal Behcet'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 Behcet'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.
Adolescence ; Adult ; Behcet's Syndrome/surgery* ; Child ; Female ; Human ; Intestinal Diseases/surgery* ; Male ; Middle Age ; Postoperative Complications ; Recurrence

OBJECTIVETo analyze the diagnosis and surgical treatment results of angio-Behçet syndrome.

METHODSThe clinical data of pre-operation diagnosis, surgical treatment methods and prospective efficacy of 26 patients who were diagnosed as Behçet syndrome between January 2003 and April 2011 was analyzed retrospectively. There were 23 male and 3 female patients, aging from 20 to 76 years with a mean of (37 ± 6) years. Among them, 3 patients showed the clinical symptoms as arterial stenosis or occlusion, 9 patients had aneurysm, 13 patients had phlebitis or phlebothrombosis. One patient had both aneurysm and venous thrombosis. Totally 11 patients had experienced 22 cases surgical treatment including interventional therapy for 8 cases, open operation for 13 cases and hybrid operation for 1 case.

RESULTSTwenty-two patients (84.6%) were followed up from 3 months to 96 months after various surgical treatment methods. The average follow-up periond was 39.3 months. Totally, perioperative mortality was 1/11 after surgical treatment. Healing rates were 7/8 and 8/13, recurrence rates were 5/8 and 7/8 in patients with interventional therapy compared with that of experiencing open surgery respectively.

CONCLUSIONSBehçet syndrome patients combined with various vascular lesions should be thought of angio-Behçet syndrome. Choosing correct surgical treatment according to patient's condition and timing of pathological changes are the keys of gaining satisfactory results.

Adult ; Aged ; Behcet Syndrome ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo summarize operational effect with surgical treatment of aortic regurgitation caused by Behcet's disease and discuss relevant surgical techniques for treatment of these conditions.

METHODSEight patients with aortic regurgitation secondary to Behcet's disease and received surgery between April 1997 and August 2003 were retrospetively analyzed. Among them, two patients had their aortic valves replaced in other hospital before admitted to our hospital where one undertook aortic valve replacement (AVR), and the other undertook aortic root replacement (ARR). In six patients who were initially treated in our hospital, the surgical procedures for aortic regurgitation included AVR in three patients and ARR operation in other three patients in whom Bentall-type operation was conducted in two patients and Cabrol-type operation in one.

RESULTSOne patient died during hospital stay. The follow-up periods ranged from 3 months to 36 months. In five patients with prosthetic valve detachment or suture detachment, redo homograft replacement was required in one patient and redo AVR in 3, one patient had redo AVR twice, and the remaining one patient had no surgery at present. Three patients primarily operated by ARR operation have no complications.

CONCLUSIONSThe rate of prosthetic valve detachment is high in patients with Behcet's disease. ARR should be a first-line therapy for operation promised these patients.

Adult ; Aortic Valve Insufficiency ; etiology ; surgery ; Behcet Syndrome ; complications ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Retrospective Studies

No abstract available.
Adult ; Behcet Syndrome/complications/*diagnosis ; Colon/blood supply/pathology/surgery ; Colonoscopy ; Gastrointestinal Hemorrhage/*diagnosis/etiology/surgery ; Humans ; Ileum/blood supply/surgery ; Male ; Rectum/blood supply/surgery

A recurrent aneurysm at the anastomosis site or the remaining artery frequently occurs after the operative treatment of an aneurysm in Behcet's disease despite anti-inflammatory medication. Herein, a ruptured left renal artery stump aneurysm in a patient with Behcet's disease, who received a left nephrectomy, aorto-biiliac bypass and heterotopic autotransplantation of the right kidney for the treatment of an abdominal aortic aneurysm and renal hypertension one year prior to this admission, is reported. An aneurysm and rupture occurred despite the administration of anti-inflammatory medications while monitoring of the clinical findings, such as skin manifestations, erythrocyte segmentation rate (ESR) and C-reactive protein (CRP). Although there is no definite proven treatment modality to prevent recurrent aneurysms at the anastomosis site or a remote artery, close follow-up with anti-inflammatory medications, and surveillance with regular intervals are the only current methods for the prevention and/or to treatment of an arterial complication in patients with Behcet's disease.
Adult ; Anastomosis, Surgical/*adverse effects ; Aneurysm, Ruptured/*etiology ; Aortic Aneurysm, Abdominal/*surgery ; Behcet Syndrome/*complications/surgery ; Human ; Hypertension, Renal/surgery ; *Kidney Transplantation ; Male ; Recurrence ; *Renal Artery ; Transplantation, Autologous

We report a rare case of neuro-Behcet's disease (NBD) presenting as an inflammatory pseudotumor in the brain. A 52-yr-old woman was evaluated for subacute dizziness and headache. Brain magnetic resonance (MR) imaging showed a right cerebellar mass, which disappeared 2 weeks later. After a year, recurrent mucocutaneous manifestations of Beh et's disease were observed. Immunosuppressant and steroid maintenance treatment were started. She experienced two more neurologic attacks and brain MR imaging revealed an enhancing mass in the right temporal lobe. The second attack showed a good response to steroid pulse therapy, but the third attack did not respond to steroid and her neurologic signs suggested an impending transtentorial hernia. The right temporal lobectomy was performed for the purpose of life-saving. The pathologic finding of the mass was a chronic inflammatory vasculitis, compatible with NBD.
Behcet Syndrome/*diagnosis/surgery ; Brain Diseases/*diagnosis/surgery ; Brain Neoplasms/*diagnosis ; Diagnosis, Differential ; Female ; Granuloma, Plasma Cell/*diagnosis/surgery ; Humans ; Magnetic Resonance Imaging ; Middle Aged

OBJECTIVETo investigate the clinical features, diagnosis methods, therapeutic principles of intestinal Behcet's disease.

METHODSking Union Medical College Hospital from August 1998 to April 2010 were retrospectively analyzed.

RESULTSThe clinical courses of patients with intestinal Behcet's disease were from 26 days to 33 years, and the average duration was 6.32 +/- 1.01 years. The appearance of extra-gastrointestinal symptoms was significantly earlier than that of gastrointestinal symptoms (7.35 +/- 1.39 years vs. 3.24 +/- 0.82 years, P<0.05). The predominant gastrointestinal manifestations were right lower quadrant pain (95.56%) and hematochezia or melena (40.00%). Misdiagnosis occurred in 17 cases. In patients without systemic medicine therapy before surgery, the incidence of postoperative infection of incision site and abdominal cavity was significantly higher than that in those undergoing systemic medicine therapy (80.00% vs. 0%, P<0.05).

CONCLUSIONSBecause of the diversity of gastrointestinal manifestations, intestinal Behcet's disease is easily misdiagnosed. The systemic medical therapy before surgery could decrease the incidence of infection of incision and abdominal cavity.

Adolescent ; Adult ; Aged ; Behcet Syndrome ; diagnosis ; pathology ; surgery ; Child ; Female ; Gastrointestinal Diseases ; diagnosis ; pathology ; surgery ; Humans ; Intestinal Diseases ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Young Adult

This report describes the case of a 45-year-old Korean female who had suffered from Behcet's syndrome for two years with a huge, unruptured aneurysm originating from the left coronary sinus. The aneurysm had caused myocardial and aortic insufficiency by compressing the proximal left anterior descending coronary artery. The orifice of the aneurysm was at the left coronary sinus, about 5mm from the left main coronary ostium, and it was filled with organized thrombi. Surgical repair was performed by closing the entrance of the aneurysm with a Dacron patch and by implementing aortic valve repair and coronary artery bypass grafting. The patient's coronary flow was restored postoperatively, and all anginal symptoms disappeared.
Aortic Aneurysm/*complications/radiography/surgery ; Behcet Syndrome/*complications ; Coronary Artery Bypass ; Female ; Humans ; Middle Aged ; Myocardial Infarction/*etiology ; *Sinus of Valsalva/surgery ; Tomography, X-Ray Computed