Eosinophilic gastroenteritis with abdominal pain and ascites: A case report.

Eosinophilic gastroenteritis (EGE) is a rare disease that presents many unspecific gastroenterological symptoms. The disease includes three types depending on the depth of eosinophil infiltration in the gastrointestinal tract. The serosal type is the most rare, presenting as ascites. A 34-year-old man presented with abdominal pain, diarrhea without bloody stool, or nausea. Laboratory test results revealed a peripheral blood eosinophil count (4.85 × 109/L), which was remarkedly elevated. Computed tomography scan demonstrated extensive intestinal wall edema thickening in the duodenum, jejunum, ascending colon and transverse colon; multiple exudative effusion surrounding the intestinal tract, and ascites in the abdominal cavity. A series of examinations excluded eosinophil elevation in secondary diseases. Endoscopic multipoint biopsy detected eosinophilic infiltration in the mucous layer of the transverse colon, with ≥ 50 eosinophils/high power field. All symptoms vanished after a few days of steroid therapy and ascites disappeared within 2 wk. EGE should be considered in patients with abdominal pain, ascites, and eosinophilia. Multiple point biopsies are essential for diagnosis.

Tian XQ ，Chen X ，Chen SL 《World Journal of Clinical Cases》

Eosinophilic ascites as an uncommon presentation of eosinophilic gastroenteritis: A case report.

Eosinophilic gastroenteritis (EGE) is defined by the presence of gastrointestinal symptoms, with an abnormal eosinophilic infiltrate of the intestine wall and exclusion of other causes of secondary eosinophilia. EGE has three clinical presentations, depending on the depth of eosinophilic infiltration of the bowel wall. It individualizes into three types, namely mucosal, muscular, and subserosal. Eosinophilic ascites, which is caused by edema and eosinophilic inflammation of the serosal layer of the small bowel wall, is the most uncommon presentation of EGE. A 30-year-old Egyptian woman presented with pain in the epigastrium and diffuse abdominal distension. Past medical history comprised allergy to iron injections (for iron deficiency anemia). Clinical examination showed moderate abdominal distention (palpation) and shifting dullness (percussion) suggestive of moderate ascites; mild right pleural effusion was also suspected, but findings were otherwise unremarkable. Abdominal and pelvic examinations by ultrasound and contrast-enhanced computed tomography showed moderate ascites, mild right pleural effusion, and diffuse thickening of the antrum and small bowel loops. Endoscopy of the upper gastrointestinal tract revealed mild diffuse hyperemia of the esophagus, stomach and duodenum, with no relevant findings in the histopathology of biopsy specimens taken from these sites. Laboratory results showed eosinophilia in the peripheral blood and marked increase of eosinophils in the ascitic fluid. Treatment with corticosteroids resulted in normalization of the laboratory test results, and the ascites resolved within a week of initiation of therapy. Eosinophilic ascites, characterized by increased eosinophils in peripheral blood and ascitic fluid, showed dramatic response to steroid therapy.

El Ray A ，Montasser A ，El Ghannam M ，El Ray S ，Valla D ... -  《-》

A patient with eosinophilic gastroenteritis presenting with acute pancreatitis and ascites.

Baek MS ，Mok YM ，Han WC ，Kim YS ... -  《-》

Eosinophilic gastroenteritis with persistent abdominal pain: a case report.

Two months ago, a 9-year-old boy experienced intermittent abdominal pain regardless of food intake, without diarrhea, bloody stool, or nausea. Blood test results revealed a peripheral blood eosinophil count of 660 cells /µL, which was marginally elevated, without inflammatory reaction, occult blood, or enteric pathogens. The intestinal mucosa from the terminal ileum to the rectum was endoscopically normal, but mucosal biopsy revealed eosinophilic infiltration of the terminal ileum and whole colon with ≥20 eosinophils/high power field (HPF). Subsequent upper gastrointestinal endoscopy revealed normal endoscopic mucosa from the esophagus to the second part of the duodenum, but mucosal biopsy showed an eosinophil infiltration of ≥20 eosinophils/HPF. Based on the above findings, he was diagnosed with eosinophilic gastroenteritis (EGE). The cause of EGE and mechanisms of eosinophil infiltration have yet to be fully elucidated. For these nonspecific abdominal symptoms, evidence of eosinophilic infiltration of the gastrointestinal mucosa, specifically 20 eosinophils/HPF in each intestinal mucosa, is required for the definitive diagnosis of EGE. Even if only persistent abdominal pain develops, EGE diagnosis should be confirmed with the analysis of mucosal biopsy in addition to the review of allergic disease history and peripheral blood eosinophil counts.

Sasaki Y ，Kajino H 《-》

Eosinophilic ascites, as a rare presentation of eosinophilic gastroenteritis.

Cuko L ，Bilaj F ，Bega B ，Barbullushi A ，Resuli B ... -  《-》