Behget's Disease vs Crohn's Disease : Differentiation with Double Contrast Barium Enema

Kim, Ki Hwang; Yoon, Sang Wook; Oh, Sei Jung; Yu, Jeong Sik; Ahn, Chang Soo; Kim, Ji Hyung

Abstract

Background/Aims; Intestinal Behcet's disease often has a serious course. However, barium enema or endoscopic examination shows nonspecific ulcers simulating other inflammatory disease, especially Crohn's disease. The purpose of this study was to identify radiologic findings which are useful to differentiate intestinal Behcet's disease from Crohn's disease.
METHODS
From January 1990 to July 1996, we experienced 14 cases of intestinal Behcet's disease and 18 cases of Crohn's disease. All the cases were confirmed by biopsy or surgery, We retrospectively reviewed the patients radiologic findings such as the sites of disease, pesence of ulcer and shape, number and depth of ulcer on barium enema.
RESULTS
The involved sites of both disease were mostly near ileocecal area. In Behcet's disease, the lesion characteristically crossed the ileocecal valve (50%) and usually involved single site of intestine. In Crohn's disease, skipped lesions were frequently observed (50%). The most common feature in Behcet's disease was the presence of ulcer. The shape of ulcer was geographic in 9 cases and irregular in 10 cases. In Crohn's disease fissuring ulcer (2), cobble stone shaped mucosa (6), stenosis (10), fistula (1) were more ofter found than in Becet's disease. Conelusions: Characteristic findings of Behcet's disease on barium enema are geographic ulcer that tends to cross ileocecal valve. The diagnosis of Crohn's disease can be considered when cobble stone shaped mucosal change, fistula, stenosis with skipped lesions are observed.