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

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

Research output: Contribution to journalArticle

32 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

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Intestinal Diseases
Laparotomy
Intestinal Perforation
Ulcer
Intestinal Fistula
Sex Ratio
Reoperation
Medical Records
Gastrointestinal Tract
Regression Analysis
Hemorrhage
Recurrence

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

Moon, Chang Mo ; Cheon, JaeHee ; Shin, Jae Kook ; Jeon, Soung Min ; Bok, Hyun Jung ; Lee, Jin Ha ; Park, Jae Jun ; Hong, Sung Pil ; Kim, Tae Il ; Kim, Namkyu ; Kim, Won Ho. / Prediction of free bowel perforation in patients with intestinal Behçet's disease using clinical and colonoscopic findings. In: Digestive Diseases and Sciences. 2010 ; Vol. 55, No. 10. pp. 2904-2911.
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title = "Prediction of free bowel perforation in patients with intestinal Beh{\cc}et's disease using clinical and colonoscopic findings",
abstract = "Background Gastrointestinal tract involvement in Beh{\cc}et'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.",
author = "Moon, {Chang Mo} and JaeHee Cheon and Shin, {Jae Kook} and Jeon, {Soung Min} and Bok, {Hyun Jung} and Lee, {Jin Ha} and Park, {Jae Jun} and Hong, {Sung Pil} and Kim, {Tae Il} and Namkyu Kim and Kim, {Won Ho}",
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Prediction of free bowel perforation in patients with intestinal Behçet's disease using clinical and colonoscopic findings. / Moon, Chang Mo; Cheon, JaeHee; Shin, Jae Kook; Jeon, Soung Min; Bok, Hyun Jung; Lee, Jin Ha; Park, Jae Jun; Hong, Sung Pil; Kim, Tae Il; Kim, Namkyu; Kim, Won Ho.

In: Digestive Diseases and Sciences, Vol. 55, No. 10, 01.10.2010, p. 2904-2911.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prediction of free bowel perforation in patients with intestinal Behçet's disease using clinical and colonoscopic findings

AU - Moon, Chang Mo

AU - Cheon, JaeHee

AU - Shin, Jae Kook

AU - Jeon, Soung Min

AU - Bok, Hyun Jung

AU - Lee, Jin Ha

AU - Park, Jae Jun

AU - Hong, Sung Pil

AU - Kim, Tae Il

AU - Kim, Namkyu

AU - Kim, Won Ho

PY - 2010/10/1

Y1 - 2010/10/1

N2 - 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.

AB - 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.

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