E Hersek | PubMed Health

PubMed1991

Intestinal Behçet's disease: surgical experience in seven cases.

Seven cases of Behçet's disease involving the intestines are reported. The terminal ileum and the ileocecal area was involved in all seven cases, with complications requiring surgical treatment. Primary right hemicolectomy and ileal resection was performed in six, and ileal resection in one patient who required a secondary right hemicolectomy because of leakage from the small bowel anastomosis. In two patients the disease was classified as complete and in five patients as incomplete. The results of this experience with seven cases of intestinal Behçet's disease have demonstrated that the complications may be serious, and that surgical treatment should be considered more readily.

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Biliary enteric fistulas.

Thirty-one patients with biliary enteric fistula who were operated on over a 19-year period (1976-1994) with an incidence of 0.74% in all biliary tract operations were reviewed retrospectively to identify etiologic factors, types of fistulas, signs and symptoms, methods of diagnosis, management and prognosis of the cases. Most common symptoms were abdominal pain, nausea, vomiting and jaundice. Two patients had gallstone ileus. The majority of the patients had severe concomitant medical illnesses. The exact preoperative diagnosis of a biliary enteric fistula was established in only five (16%) patients. In 81% of the cases fistula was secondary to chronic calculous biliary tract disease. Postoperative complications included wound infection in six (19%), biliary fistula in two (6%) and erosive gastritis in one (3%) patient. Two patients died of intra-abdominal sepsis and two of cardiac failure, with an operative mortality of 13%. Early elective cholecystectomy is recommended to avoid complications of chronic calculous cholecystitis such as bilioenteric fistulas and their increased mortality and morbidity.

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