Prediction of free bowel perforation in patients with intestinal Behçet's disease using clinical and colonoscopic findings

Chang Mo Moon, Jae Hee Cheon, Jae Kook Shin, Soung Min Jeon, Hyun Jung Bok, Jin Ha Lee, Jae Jun Park, Sung Pil Hong, Tae Il Kim, Nam Kyu Kim, Won Ho Kim

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33 Citations (Scopus)

Abstract

Background Gastrointestinal tract involvement in Behçet's disease (BD) often requires surgical intervention due to serious complications such as intestinal perforation, fistula formation, or massive bleeding. Aim The aims of this study were to investigate the clinical and surgical features of free bowel perforation and to determine the risk factors associated with this complication in intestinal BD patients. Methods We reviewed the medical records of 129 patients with intestinal BD treated from September 1988 to September 2008. Among them, 33 patients had intestinal perforations and all underwent emergent or elective laparotomy. Results The mean age of the patients with bowel perforation was 34.8 ± 15.6 years (range 12-70 years) with a sex ratio of 2.3:1 (male:female). Twenty-seven (81.8%) patients were diagnosed with intestinal BD preoperatively, whereas six (18.2%) patients were diagnosed by pathological examination after operation. Fourteen (42.4%) patients experienced postoperative recurrence of intestinal BD and 11 (33.3%) underwent reoperation. Multivariate Cox hazard regression analysis identified younger age (≤25 years) at diagnosis (HR = 3.25; 95% CI, 1.41-7.48, p = 0.006), history of prior laparotomy (HR = 5.53; 95% CI, 2.25-13.56, p = 0.0001), and volcano-shaped intestinal ulcers (HR = 2.84; 95% CI, 1.14-7.08, p = 0.025) as independent risk factors for free bowel perforation in intestinal BD. Conclusions According to the results of our study, patients diagnosed with intestinal BD younger than 25 years, who had a history of prior laparotomy or volcano-shaped intestinal ulcers have an increased risk of free bowel perforation.

Original languageEnglish
Pages (from-to)2904-2911
Number of pages8
JournalDigestive diseases and sciences
Volume55
Issue number10
DOIs
Publication statusPublished - 2010 Oct 1

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

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