Massive gastrointestinal bleeding due to the rupture of arterial aneurysm in Behçet’s disease: case report and literature review

Massive gastrointestinal bleeding is a very rare manifestation of gastrointestinal Behçet’s disease, mainly from the gastrointestinal mucosal lesions. We report herein the case of a 50-year-old man with intestinal Behçet’s disease who suffered massive hemorrhage from ruptured arterial aneurysm. Colonoscopy demonstrated large amount of fresh blood in the entire colon, but we were not able to localize bleeding focus anywhere in the colon. Angiography was performed and it revealed that a small aneurysm on the right ileocolic artery with apparent extravasation of contrast material. A guiding catheter was inserted to a right ileocolic artery and superselective arterial embolization using microcoils was successful. Following this procedure, the gastrointestinal bleeding gradually subsided and completely stopped within a few days. He is now treating with prednisolone and sulfasalazine without recurrent bleeding until now.