Intestinal Behçet’s Disease Presenting as Recurrent Gastrointestinal Perforation: A Diagnostic Pitfall Mimicking Crohn’s Disease

A 24-year-old man underwent four emergency surgeries for gastrointestinal perforation over a six-year period. Surgical pathology repeatedly suggested transmural inflammation with fissuring ulcers, favoring Crohn’s disease. However, the acute onset of each episode and the lack of typical Crohn’s disease-related chronic inflammatory symptoms between episodes were incompatible with the chronic course of Crohn’s disease. The histopathological finding of a tunnel-like ulcer, together with recurrent oral ulcers and acneiform folliculitis, led to a diagnosis of intestinal Behçet’s disease after multidisciplinary review. This case illustrates that when pathological morphology and clinical rhythm conflict, a comprehensive evaluation integrating the clinical history, extraintestinal manifestations, and histopathological findings is essential.