Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2021; 9(12): 2854-2861
Published online Apr 26, 2021. doi: 10.12998/wjcc.v9.i12.2854
Behcet’s disease manifesting as esophageal variceal bleeding: A case report
Wen-Xing Xie, Hai-Tao Jiang, Guo-Qing Shi, Li-Na Yang, Hong Wang
Wen-Xing Xie, Hai-Tao Jiang, Guo-Qing Shi, Li-Na Yang, Hong Wang, Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Author contributions: Jiang HT, Shi GQ and Wang H were the patient’s gastroenterologists, reviewed the literature, and contributed to manuscript drafting; Yang LN and Xie WX gathered information and contributed to manuscript drafting; Xie WX and Wang H were responsible for the revision of the manuscript for important intellectual content; and all authors issued final approval for the version to be submitted.
Supported by Zunyi City Science and Technology Plan Tasks (2019), No. 2019-103.
Informed consent statement: The family members of this case patient have provided informed written consent before undergoing gastroesophageal examination and esophageal varices bleeding treatment surgery.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong Wang, MM, Professor, Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, No. 201 Dalian Road, Huichuan District, Zunyi 563000, Guizhou Province, China. wanghong89zy@163.com
Received: November 19, 2020
Peer-review started: November 19, 2020
First decision: January 7, 2021
Revised: January 13, 2021
Accepted: February 23, 2021
Article in press: February 23, 2021
Published online: April 26, 2021
Processing time: 146 Days and 16.3 Hours
Abstract
BACKGROUND

Behcet’s disease (BD) is a chronic disease characterized by oral and vulvar ulcers as well as eye and skin damage and involves multiple systems. It presents as an alternating process of repeated attacks and remissions. Esophageal venous rupture and bleeding caused by BD is rarely reported at home and abroad. This paper reports a case of bleeding from oesophageal varices caused by BD, aiming to provide an additional dimension for considering the cause of bleeding from esophageal varices in the future.

CASE SUMMARY

A 38-year-old female patient was admitted due to a gradual increase in shortness of breath and chest tightness after the activity, and was admitted to our hospital for treatment. After admission, relevant examinations showed that the patient had multiple blood clots. Four days after admission, she suddenly experienced massive hematemesis. Emergency esophagogastroduodenoscopy revealed bleeding from esophageal and gastric varices. The patient had no history of viral hepatitis or drinking habits, and no history of special genetic diseases or congenital vascular diseases. There is no obvious abnormality in liver function. After reviewing the medical history, it was found that the patient had recurred oral ulcers since childhood, ulcers were visible in the perineum during menstruation, and there was an intermittent red nodular rash and uveitis. The current skin acupuncture reaction is positive, combined with the evaluation of the external hospital and our hospital, the main diagnosis is BD. She received methylprednisolone, cyclophosphamide, immunomodulation, acid suppression, gastric protection, and anticoagulation and anti-infection treatments, and was discharged from the hospital. During the 1-year follow-up period, the patient did not vomit blood again.

CONCLUSION

This case highlights bleeding from esophageal varices caused by BD, aiming to provide an additional dimension concerning the cause of bleeding from esophageal varices in the future.

Keywords: Behcet's disease; Vasculitis; Vascular embolism; Esophageal variceal bleeding; Case report

Core Tip: Esophageal venous rupture and bleeding caused by Behcet’s disease is rarely reported at home and abroad. This article reports a case of portal hypertension caused by Behcet’s disease and rupture of esophageal varices, which can provide some help for clinical diagnosis and treatment.