Intestinal Behgets Disease

Behcet's disease is a systemic inflammatory disease of unknown etiology with primary symptoms of recurrent oral aphtha, skin symptoms, eye symptoms, and vulval ulcers. The disease, accompanied by intestinal lesions, is called intestinal Behcet's disease. Common intestinal lesions include round or oval deep ulcers in the ileocecal region. In some cases, however, ulcerative lesions are not present in the ileocecal region but are present in other regions in the small intestine; therefore, examination of the distal small intestine by double-balloon endoscopy is useful. There may be atypical lesions, such as small, shallow ulcers and aphthoid ulcers in the large intestine. Histological findings of the lesions are nonspecific chronic inflammatory changes without specific characteristics (Fig. 10.4.2).



Ulcerative Lesion and Surrounding Villi

Swollen or edematous villi are often found around ulcerative lesions in the small intestine. When the double-balloon endoscope is used to observe the small intestine, attention should be given to villous abnormalities in the field of view to locate ulcerative lesions. These appear to be a consequence of the influence of inflammation of localized lesions on the surrounding villi.

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