A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, reccurent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years.
Above the chief complaints were remission or exacerbation during hospitalization. Physical examination showed that left radial, ulnar & brachial pulse was not palpable.
No bruit or murmur was obtained over the mass.
Neurologic examination revealed no significant finding.
On admission, chest P-A showed hen egg sized round & oval compacthazy density on left upper lung field.
Bronchogram revealed no pathological finding and Lt. tomogram showed well define large ovoid mass density in the superior mediastinum. Fluoroscopy finding showed non pulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out aortic aneyrysm, exploratory operation was performed through the 2nd intercostal space, Lt.
It was performed that the mass was ascending aortic aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft.
post-op. control I.V.C graphy showed completly obstruction sign. Post-op. control aortography reveald good surgical result.
Final, histopathological answered non-specific aortic aneurysm, saccular tepe. Post-op. courses were unevenful except mild neurologic disturbance with subclaviansteal syndrome and associated with both lower leg pitting edema due to inferior vena, cova obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet´s syndrome reviewed with related literatures.
The coexistence of mouth and genital ulceration with hypopyon metioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937.
In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a chronic course, blindness beinge the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al (1951) giving an incidence of 25% and Dowling (1961) 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae (Thomas, 1947: Boolukos 1960) are recorded.
Little attention has been paid to arterial involvement.
Mishima et al. (1961) described resection of an aortic aneurysm in a 38 year old man with Behcet´s syndorme.
Mounsey in a cilnicopathological conference described a case (Brit, med. J ,1966) of ruptured aortic aneurysm in Bechcet´s syndrome treated by aorto-iliac graft.
Also, Shikano and Oshima et al (1963) recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet´s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet´s Dz. appeared to form part of this generalized disease. This is a case report of surgical experience of Befcet´s Dz. with ascending aortic aneurysm which had nearly all the typical clinical features. Above metioned and was reviewed with related literatures.
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