A Thinking about Long-time Misdiagnosis and Mistreatment of Elderly Patients with Intestinal Behcet's Disease

WANG Shuai; ZHANG Fan; ZHANG Wei; QIAN Zhen

doi:10.3969/j.issn.1002-3429.2017.06.017

Abstract：Objective To analyze clinical features, diagnosis points and misdiagnosis causes of intestinal Behcet's disease in order to improve understanding of the disease.Methods Clinical data of 1 patient with intestinal Behcet's disease was retrospectively analyzed.Results The patient visited a doctor for vague pain in sternum and upper abdomen after eating for more than 7 months.The Patient had visited many hospitals, and been misdiagnosed as having gastritis, peptic ulcer, Crohn's disease and intestinal tuberculosis, and then corresponding treatments were given without symptoms remission.Physical examination showed that one ulcer in the oral cavity, obvious tenderness on upper abdomen and severe edema in both lower extremities.Fecal occult blood was positive, and endoscopy showed multiple esophageal ulcers and multiple superficial ulcers in stomach.A history of repeated oral ulcer 2 years ago was gotten by asking history, and the patient had impaired vision recently, and then intestinal Behcet's disease was confirmed by experts' consultation.Treatments such as Methylprednisolone, Thalidomide, acid suppression and stomach protective treatment were given, and the patient was discharged after condition improved.During 3 months of follow-up, the ulcer healed without recurring vague pain in sternum and upper abdomen after eating.Conclusion Clinicians should take into account the possibility of intestinal Behcet's disease for patients having gastrointestinal ulcer and repeated oral ulcer, and related medical examination should be performed in time and acupuncture test if it is necessary to diagnose and treat as early as possible to avoid misdiagnosis and mistreatment.