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Case No. 709
2025-01-01~2025-01-31
출제자 : 박상익
Hit : 471
| Period | 2025-01-01~2025-01-31 |
|---|---|
| Diagnosis | Behçet's disease |
| Gender |
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| Age | 22 |
| Clinical information | 8개월 전 복부수술의 과거력이 있는 22세 남자 환자로 1주일 전부터 시작된 좌측 목과 우측 사타구니 통증을 주소로 내원하였다. 본 CT 소견과 복부수술의 원인이 된 질환은? |
| Discussion | On contrast-enhanced CT scans of the neck and pelvis, filling defects are seen in the left internal jugular and right common femoral veins, accompanied by wall thickening, enhancement, and surrounding infiltrations, suggestive of thrombophlebitis. Additionally, the right internal jugular, subclavian, and right brachiocephalic veins are obliterated, with collateral vessels forming in the upper thoracic wall. These findings suggest a chronic, progressive inflammatory condition involving multiple veins. The cause of the bowel surgery in this patient was bowel perforation due to Behçet’s disease, which can also cause venous thrombosis/thrombophlebitis. Most clinical manifestations of Behçet’s disease are believed to be due to vasculitis. Unlike other systemic vasculitides, Behçet’s disease is remarkable for its ability to affect blood vessels of all sizes—small, medium, and large—on both the arterial and venous sides of the circulation. Venous involvement in Behçet’s disease can present as deep venous thrombosis, subcutaneous thrombophlebitis, superior vena cava (SVC) occlusion, inferior vena cava (IVC) occlusion, cerebral sinus thrombosis, Budd-Chiari syndrome, and other forms of venous obstruction. Reference 1. Koç Y, Güllü I, Akpek G, Akpolat T, Kansu E, Kiraz S, et al. Vascular involvement in Behçet's disease. J Rheumatol. 1992;19(3):402-10. |
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