A rare case of Behçet's disease complicated by Budd-Chiari syndrome and perforated duodenal ulcers in a young male.

Abstract

Behçet's disease (BD) is characterized by skin lesions, uveitis, and recurrent oral and genital ulcers. Vascular problems, predominantly affecting veins, lead to thrombosis, increasing the risk of ruptured artery aneurysms and Budd-Chiari syndrome (BCS). Morbidity and mortality are significantly heightened by rare occurrences such as pulmonary artery aneurysms, cardiac involvement, and BCS. Prompt diagnosis and treatment are pivotal for prognosis improvement, particularly in males with early onset. We present a case of a 16-year-old male with BD history, who developed abdominal distension, pedal edema, and shortness of breath. Clinical examination and laboratory findings revealed thrombosis in the right popliteal vein and BCS. Despite the initiation of lifelong anticoagulation therapy, the patient later suffered a gastrointestinal bleed from perforated duodenal ulcers, necessitating emergency intervention. Given a high Model for End-Stage Liver Disease (MELD) score and associated mortality risk, the patient was promptly referred for liver transplantation.