A case of Behçet's disease with multiple longitudinal ulcers all over the colon

Abstract

We experienced a rare case of intestinal Behçet's disease simulating Crohn's colitis. A 70-yr-old female presented oral and genital ulcers, erythema nodosum, arthralgias, and abdominal pain. Regardless of our efforts, she died of septic shock. Autopsy showed punched-out ulcers in the terminal ileum and multiple longitudinal ulcers with inflammatory polyposis spreading from the ascending to the descending colon. The differential diagnosis of intestinal Behçet's disease versus Crohn's disease was difficult. However, microscopic findings showed nonspecific ulceration, and no evidence of Crohn's disease could be found. Clinically, the patient met the criteria of Behçet's disease, and punched-out ulcers in the ileocecal region, which is characteristic of intestinal Behçet's disease, confirmed the diagnosis of Behçet's colitis. Although rarely encountered, multiple longitudinal ulcers can involve all of the colon in Behçet's disease, like Crohn's disease.