Abstract:

Behcet’s disease (BD) is a chronic vascular inflammatory disease of unknown causes. It is called intestinal BD, when digestive tract is involved. To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December, 2010 to April, 2014 in Peking University People’s Hospital. General information, clinical feature and endoscopic feature were presented, and literatures were reviewed. There were 3 male and 2 female patients. Age range was from 23 to 55 years old (median age 40 years old). Disease course was from 3 days to 28 years (median course 9 years). 4 patients were diagnosed as systemic BD, and the rest independent intestinal BD. 4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion. They all had gastrointestinal symptoms, including retrosternal pain (2 cases), hematochezia (3 cases), diarrhea (3 cases) and abdominal pain (2 cases). 1 patient had a history of fistula of ileocecal junction and underwent caecectomy. 5 patients all underwent whole digestive tract examination by endoscopy, including gastroscopy, colonoscopy and capsule endoscopy.Except of 1 normal result of colonoscopy, all endoscopy results revealed lesions. Capsule endoscopy results of all patients were abnormal. Types of small intestinal lesion were various, including ulceration, erosion, protrusion and vasculopathy. All digestive tract can be involved in BD patients. Capsule endoscopy can evaluate lesions throughout whole digestive tract, especially in small intestine. As a consequence, it is helpful to explain gastrointestinal symptom, increase early diagnostic rate. Intestinal BD (IBD) mainly involves small bowel, and ileum is the major involved segment, not only limited in ileocecum. The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn’s disease.This is the first time to report capsule endoscopic feature of BD patients in China.

Key words: Capsule endoscopy, Behcet syndrome, Intestinal diseases, Crohn disease