Abstract
A case of Behçet's disease (BD) with occlusion of both caval veins and “downhill” esophageal varices is reported. A 59-year-old male patient had esophageal varices, established as the “downhill” type by endoscopy, venography, and contrast-enhanced computed tomography (CE-CT) scan. Venography via both jugular veins did not lead to the visualization of the superior vena cava (SVC), but revealed numerous collateral veins, which formed esophageal varices en route. Venography via both femoral veins did not lead to the visualization of the inferior vena cava (IVC), but revealed numerous collateral veins, which flowed into the portal vein together with the jugular flow. CE-CT scan revealed the disappearance of the SVC and the lower part of the IVC, below the hepatic vein. The patient was diagnosed as having BD, based on his history of recurrent oral and skin lesions over the past 26 years.
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References
O'Duffy JD. Behçet's disease. In: Kelly WN, et al. (eds) Textbook of rheumatology. 3rd ed Philadelphia: WS Saunders, 1989;1209–1214.
Shimizu T. Vascular lesion of Behçet's disease (in Japanese). Cardioangiology 1977;1:124–131.
Koc Y, Gullu I, Akpek G, et al. Vascular involvement of Behçet's disease. J Rheumatol 1992;19:402–410.
Momoi H, Inaba G, Mimura Y. Guidance for diagnosis of Behçet's disease, guidance as to diagnosis and treatment for Behçet's disease (in Japanese with English abstract). Inaba G (ed) Behçet's Disease Research Committee of Japan, Ministry of Welfare, Tokyo: 1982;1–10.
Japanese Research Society for Portal Hypertension. The general rules for recording endoscopic findings on esophageal varices. Jpn J Surg 1980;10:84–87.
Agata T, Maeda K, Nakae K. Report on a nation-wide survey on Behçet's disease (in Japanese with English abstract). Inaba G (ed) Behçet's Disease Research Committee of Japan, Ministry of Welfare, Tokyo: 1980;196–201.
Dundar S, Yazici H. Superior vena cava syndrome in Behçet's disease. Vasc Surg 1984;18:28–33.
Kansu E, Ozer FL, Akalin E, et al. Behçet's syndrome with obstruction of the venae cavae. Quart J Med New Series XLI 1972;162:151–168.
Ishikawa R, Noguchi T, Matsumoto K. A case of “downhill” esophageal varices. Behçet's disease associated with abdominal aortic aneurysm and occlusion of the superior and inferior vena cava (in Japanese with English abstract). J Jpn Surg Soc 1986;7: 1576–1582.
Takeichi T, Masuda K, Watanabe S, et al. “Downhill” esophageal varices associated with superior vena cava thrombosis caused by vasculo-Behçet's disease (in Japanese with English abstract). Report of a case. Gastroenterol Endosc 1987;22: 296–301.
Ishida M, Matsuyama H. A prognostic evaluation of endoscopic injection sclerotherapy for esophageal varices. Gastroenterol Jpn 1989;24:347–356.
Lie JT. Vascular involvement in Behcet's disease. Arterial and venous and vessels of all sizes. J Rheumatol 1992;19:341.
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Orikasa, H., Ejiri, Y., Suzuki, S. et al. A case of Behçet's disease with occlusion of both caval veins and “downhill” esophageal varices. J Gastroenterol 29, 506–510 (1994). https://doi.org/10.1007/BF02361251
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DOI: https://doi.org/10.1007/BF02361251