The intestinal lesion of Behcet's colitis shows aphthoid or punched-out ulceration. But these morphological characteristics are variable and the clinical course of Behcet's colitis is also diverse. There have been many case reports since 1962,
but
there
is few study for clinical course or for morphological characteristics of intestinal lesion of Behcet's colitis. So we retrospectively investigated the clinical course of Behcet's colitis according to colonoscopic findings. Thirty-two patients
with
Behcet's colitis were investigated retrospectively from January 1984 to July 1994. The patients who had at least two major stigmata of Behcet's syndrome with intestinal lesions were included, and whose colonoscopic films were available and whose
follow-up studies were done, The studies used at their follow up were colonoscopy and/or barium enema. In our study the patients ranged in age from 15 to 64 years old, with mean age of 37 years old; 28% were in 3rd decade. The mean follow-up
period
was
33 months.
The macroscopic finding could be classified into 3 types; volcano-shape ulcer, geographic ulcer, and aphthous ulcer. The volcano shaped ulcers that were deep ulcers with nodular margins, converging folds or pseudopolyps were 17 cases, the
geographic
ulcers that were irregular and rather shallow ulcers with clear edges were 8 cases, and the aphthous ulcers that were ovoid or round, shallow and discrete ulcers were 7 cases. In clinical course, 9(53%) out of 17 cases with volcanoshaped ulcer
received
operation, 1(16%) out of 17 responded to medical treatment, and 7 cases(41%) didn't respond to medical treatment. While in group of geographic ulcer or aphthous ulcer, 1 case, respectively, (13% of geographic ucer, 14% of aphthous ulcer) received
operation and 5 cases in each group (63%, 71% respectively) responded to medical treatment. From these results, we could conclude that the ulcerative lesions of Behcet's colitis classified as volcano shape tend to respond to medical treatment
less
favorably than those classified as non-volcano shaped ulcer. Moreover, this type has much higher chance of receiving operation than the other two types. (Kor J Gastrointest Endosc 16:30~38, 1996)
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