Vasculo-Behçet's disease with a giant pseudoaneurysm of superficial femoral artery: A case report

INTRODUCTION AND IMPORTANCE: Behçet's Disease is a chronic, multi-systemic vasculitis of unknown aetiology that classically presents with a triple-symptom complex of recurrent oral ulcers (aphthous stomatitis), genital ulcers and uveitis (chronic iridocyclitis). Vascular involvements of Behçet disease include arterial and venous thrombosis, formation of an unusual aneurysm and arterial occlusion, known as vasculo-Behçet's disease. CASE PRESENTATION: A 21-year-old male presented with recurrent painful oral ulcers and bilateral lower limb deep vein thrombosis. Also, he presented with thigh pain and swelling, diagnosed as a giant pseudoaneurysm of the right SFA. CT angiography revealed an 80.2 × 76.9 × 69 mm pseudoaneurysm. He was scheduled to undergo emergency surgery due to severe, intractable pain. The pseudoaneurysm was excluded, and using a reversed basilic vein graft interposition, we performed a femoral-femoral bypass from the proximal femoral artery to a distal superficial femoral artery. Postoperatively, the patient had an uneventful course; pain and swelling subsided. CLINICAL DISCUSSION: The diagnosis of Behçet's disease is based on clinical criteria consisting of combinations of symptoms due to the lack of universally recognised pathognomonic laboratory tests. Arterial complications of Behçet's disease occur in 1 % to 7 % of patients, with a male predominance. Immunosuppressants, such as cyclophosphamide or azathioprine, represent the mainstay treatment of Behçet's disease and should always be considered to achieve complete remission, prevent recurrences, and reduce the risk of postoperative complications. CONCLUSION: Pseudoaneurysm is the most common presentation of arterial complications of Vasculo- Behçet's disease and should be kept in mind to prevent significant morbidity and mortality.