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

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

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

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

Behcet's disease is an inflammatory disorder of unknown etiology with multi-organ involvement. Although it rarely involves the heart, once the heart is involved the results can be devastating. However, since cardiac involvement has various manifestations, diagnosis is challenging. The clinical features and echocardiographic findings of cardiac Behcet's may mimic culture-negative infective endocarditis. A correct diagnosis is usually made postoperatively. Here, we report the case of a 55-year-old male who was initially diagnosed with infective endocarditis that caused metastatic vertebral osteomyelitis. He underwent immediate cardiac surgery and received empirical antibiotics, but all culture findings were negative; however, he had a sustained fever and elevated inflammatory marker levels. After reviewing the results of pathologic and imaging studies, a final diagnosis of cardiac Behcet's disease was made. He was successfully treated with a high dose of corticosteroids. This report demonstrates a rare case of cardiac Behcet's disease mimicking culture-negative infective endocarditis.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Behcet Syndrome ; Diagnosis ; Echocardiography ; Endocarditis* ; Fever ; Heart ; Humans ; Male ; Middle Aged ; Osteomyelitis ; Spondylitis ; Thoracic Surgery

We describe a case of Behcet's disease (BD) which showed the ileocecal ulcer and cecocecal fistula. This 38-year-old man had appendectomy six years ago because of colicky pain in the right lower abdomen (RLA). There are some reports on fistula formation in BD. In those, some are related to surgery and others are not. BD with cecocecal fistula, possibly associated with a past operation, has not been reported in the literature.
Adult ; Appendectomy ; Behcet's Syndrome/diagnosis ; Behcet's Syndrome/complications+ACo- ; Case Report ; Cecal Diseases/surgery ; Cecal Diseases/etiology+ACo- ; Follow-Up Studies ; Human ; Ileal Diseases/surgery ; Ileal Diseases/etiology+ACo- ; Intestinal Fistula/surgery ; Intestinal Fistula/etiology+ACo- ; Male ; Ulcer/surgery ; Ulcer/etiology+ACo-

Behcet's disease has been recognized as a systemic vasculitis characterized by the involvement of multiple organs such as orogenital ulcers, eye lesions including uveitis and optic neuritis, and skin lesions including folliculitis and erythema nodosum. Vascular involvement occurs occasionally and is classified into thrombosis and aneurysm. However, massive gastrointestinal bleeding from arterial aneurysm is a rare manifestation of intestinal Behcet's disease. Recently, we experienced a case of intestinal Behcet's disease presenting with massive gastrointestinal bleeding due to aneurysmal rupture of ileo-colic artery. A 30-year-old male with Behcet's disease was admitted because of massive gastrointestinal bleeding. A large ileo-cecal ulcer was revealed as a bleeding focus on colonoscopic examination. Celiac angiography showed aneurysm and stenosis of ileo-colic artery. After the failure of hemostasis with arterial embolization, ileocecectomy was performed. After the resection hematochezia was completely stopped.
Adult ; Aneurysm, Ruptured/complications/*diagnosis ; Behcet Syndrome/complications/*diagnosis ; Cecum/*blood supply/pathology/surgery ; Celiac Artery/radiography ; Colonoscopy ; Gastrointestinal Hemorrhage/*diagnosis/etiology ; Humans ; Ileum/*blood supply/pathology/surgery ; Male ; Tomography, X-Ray Computed