A Unique Case Report of Solitary Transverse Colon Perforation in Behcet’s Disease

Behcet’s disease (BD) is a multi-systemic inflammatory vasculitis with a highly variable and relapsing course. We describe a rare and interesting presentation of severe BD involving a focal perforation of the transverse colon, followed by a concise overview of the natural history, pathogenesis, clinical presentation, and treatment of BD. Gastrointestinal (GI) ulceration can occur throughout the small bowel and colon, although solitary lesions are often found in the terminal ileum whereas in the colon multiple shallower ulcers spread throughout are more typical presentations. Despite our patient’s lesion being in the transverse colon, the remainder of our patient’s bowel was unaffected. First line treatment for gastrointestinal perforation is surgical resection, which our patient promptly underwent. This report highlights the importance of maintaining a high index of suspicion for potential life-threatening complications among BD patients presenting with GI symptoms such as nausea, vomiting, diarrhea and abdominal pain. It also highlights the lack of current guidelines pertaining to post-operative surveillance colonoscopy and medical management in this population.