Eosinophilic gastroenteritis with hemorrhagic ascites: a case report

Abstract

BACKGROUND Eosinophilic gastroenteritis is a rare pathology, of undetermined etiology which incidence is in increase. It is characterized by eosinophilic infiltration of the wall of the gastrointestinal tract. Clinical manifestations are very variable and the severity of the clinical picture depends on the site involved and the wall layers infiltrated. AIM We point out the clinical, evolutionary and therapeutic characteristics of this rare affection. CASE REPORT We report the case of a 65 years old man, with the history of allergic asthma. He was admitted for diarrhea associated with vomiting and slimming quantified to 3 kg in 3 weeks. Physical examination noted an edematous-ascitic syndrome. Biology showed the presence of high peripheral eosinophilia. Paracentesis disclosed exudative effusion with high level of eosinophil. The morphological assessment highlighted a segmental parietal thickening of the small intestine and a dense eosinophilic infiltration of the mucosal duodenal layer. The patient was treated by corticotherapy with a favorable evolution. CONCLUSION Despite its rarity, the diagnosis of gastroenteritis with ascites should be evoked even when the etiologic assessment is negative.