Comparison of Clinical Findings in Intestinal Behçet Disease and Simple Ulcer

Abstract

Purpose: Intestinal Behçet disease (BD) and simple ulcer (SU) are refractory diseases of unknown etiologies that often develop in the ileocecal region. Although they are usually considered as distinct diseases with regard to both prognosis and treatment, there are no universally accepted grounds by which they are clinically distinguished. The aim of this study is to clarify the diagnosis of both diseases by their clinical presentations, endoscopic findings, and respective status as clinical entities. Methods: Sixty -six patients with BD, either in our hospital or related facilities were reviewed. Of the sixty-six patients, nineteen patients with BD and six patients with SU in the ileocecal region were observed. The diagnosis was based on international criteria. The follow-up period of both diseases spanned from 1999 till 2008. Results: 1) There was no significant difference in the age of onset of the two diseases. 2) The percentage of men experienced incidence of SU was higher than the percentage of men experienced incidence of BD. 3) Abdominal pain and melena were frequently observed in patients with both diseases. 4) SU patients tended to exhibit single ulcers, whereas multiple ulcers were frequently observed in BD. The gross appearance of ulcers was similar, with punched-out lesions and similar shapes observed in both diseases. 5) In BD, lesion in upper gastrointestinal tract was observed in three cases, whereas no such cases were observed for SD. Lesions appeared in the large intestine in six cases and one case of BD and SU, respectively. Among the six cases with BD, small ulcer was scattered in five of the cases, while one case showed deep and large ulcer. 6) Only one surgery was performed in a case of SU with a previously described legion of the large intestine. 7) Long manifestation periods for both diseases were more likely to be severe. Conclusion: There results show that there were differences between BD and SU, regarding patient gender as well as the number and distribution of ulcers. However, since the number of reported cases is small, it is difficult to specify the precise difference between BD and SU. Therefore, further investigations and development of effective treatment for both diseases will be necessary in the future.