Esophagobronchial fistula in a patient with Behcet's disease: Report of a case
Esophagobronchial fistula in a patient with Behcet's disease: Report of a case
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DOI：
10.1007/s00595-004-2975-2
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发表时间：
2005-08-01
期刊：
影响因子：
2.5
通讯作者：
Nishikawa, K
中科院分区：
文献类型：
--
作者：
Morimoto, Y;Tanaka, Y;Nishikawa, K
白塞氏病食管受累通常被认为非常罕见。迄今为止，英文文献中已描述了 6 例与白塞病穿孔、穿透或瘘管相关的食管溃疡病例。本报告描述了一名肠道白塞氏病患者的食管支气管瘘。一名62岁男性，因阑尾切除术后小肠穿孔，因腹膜炎转入我院。 14岁时，他患有复发性口腔溃疡。发现回肠溃疡和附睾炎，病理检查显示非特异性炎症。此外，诊断出食管溃疡合并食管支气管瘘。瘘管不仅需要内镜治疗，还需要手术干预。该患者的临床特征符合肠道白塞病的活动期。无需任何治疗，症状逐渐消失。然而，缓解四年后，症状再次出现，出现胃肠道出血和多关节炎。在回结肠区域，观察到穿孔性溃疡。根据临床病史和特征，诊断为与复发性胃肠道溃疡相关的白塞氏病。开始类固醇治疗（泼尼松龙，每天 20 毫克），症状迅速缓解。该患者目前正在接受门诊随访，同时接受泼尼松龙（每天 10 毫克）治疗，没有任何胃肠道症状。
Esophageal involvement in Behcet's disease is generally considered to be very uncommon. So far, six cases of esophageal ulcers associated with perforation, penetration, or fistula in Behcet's disease have been described in the English literature. This report describes esophagobronchial fistula in a patient with intestinal Behcet's disease. A 62-year-old man was transferred to our hospital for peritonitis due to a small intestinal perforation after an appendectomy. At the age of 14 years he had had recurrent oral ulcers. Ulcerations of the ileum and epididymitis were found, and a pathological examination revealed nonspecific inflammation. Furthermore, an esophageal ulcer with esophagobronchial fistula was diagnosed. The fistula required not only endoscopic treatment but also surgical intervention. The patient's clinical features were consistent with the active phase of intestinal Behcet's disease. The symptoms gradually resolved without any treatment. Four years after remission, however, the symptoms recurred with gastrointestinal hemorrhage and polyarthritis. In the ileocolic region, punch-out ulcerations were noted. The clinical history and features led to a diagnosis of Behcet's disease associated with recurrent gastrointestinal ulcerations. Steroid therapy (prednisolone, 20 mg daily) was started, and led to a rapid resolution of the symptoms. The patient is now being followed up as an outpatient while receiving prednisolone (10 mg per day), without complaint of any gastrointestinal symptoms.