Eosinophilic Gastroenteritis with Abdominal Pain and Ascites: A Case Report

Abstract

Background 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. Case Summary 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. Conclusion EGE should be considered in patients with abdominal pain, ascites, and eosinophilia. Multiple point biopsies are essential for diagnosis.