Ulcerative Fistulizing Ileitis Presenting a Diagnostic Dilemma between Crohn’s Disease and Intestinal Behçet’s Disease: A Case Report and Literature Review
N. Bouhdoud *
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
A. Sadik
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
F. Machayi
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
H. Aouroud
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco and Physiology Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco.
O. Nacir
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
F. Lairani
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
A. Ait Errami
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
S. Oubaha
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco and Physiology Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco.
Z. Samlani
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
K. Krati
Hepato-Gastroenterology Department, University Hospital of Mohammed VI, Marrakesh, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Behçet’s disease is a rare systemic vasculitis that can affect the gastrointestinal tract. Intestinal involvement, or enteric Behçet’s disease, can mimic Crohn’s disease, making the differential diagnosis complex, particularly in chronic and fistulizing forms. We report the case of a 37-year-old man being treated for Behçet’s disease, presenting with ulcerative ileitis with pelvic fistulas, bilateral osteonecrosis of the femoral heads, and a prolonged course of the disease. Imaging findings and the lack of response to Behçet’s disease treatment led, following multidisciplinary consultation, to a diagnosis of Crohn’s disease. This case illustrates the diagnostic challenges posed by intestinal forms of Behçet’s disease that mimic chronic inflammatory bowel disease.
Keywords: Behçet's disease, Crohn's disease, enteropathology associated with Behçet's disease, ulcerative ileitis, gastrointestinal fistulas, differential diagnosis