Agrawal S, Vohra S, Rawat S, Kashyap V. Eosinophilic ascites: A diagnostic and therapeutic challenge. World J Gastrointest Surg 2016; 8(9): 656-659 [PMID: 27721930 DOI: 10.4240/wjgs.v8.i9.656]
Corresponding Author of This Article
Shefali Agrawal, MD, MS, FACS, Senior Consultant, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Delhi Mathura Road, Sarita Vihar, New Delhi 110076, India. shefali_a@apollohospitals.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
Sandeep Vohra, Department of Radiology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
Sangeeta Rawat, Vikas Kashyap, Department of Pathology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
Author contributions: Agrawal S contributed to study conception and design and drafting of manuscript; Agrawal S, Vohra S, Rawat S and Kashyap V contributed to acquisition of data and critical revision.
Institutional review board statement: As per our institutional policy, permission by the Institutional review board is not required for publication of case reports.
Informed consent statement: As per our institutional policy, once all information pertaining to the unique markers of the patient’s identity have been deleted from the case report an informed consent from the patient is not necessary.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shefali Agrawal, MD, MS, FACS, Senior Consultant, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Delhi Mathura Road, Sarita Vihar, New Delhi 110076, India. shefali_a@apollohospitals.com
Telephone: +91-81-30009660
Received: May 24, 2016 Peer-review started: May 25, 2016 First decision: July 6, 2016 Revised: July 12, 2016 Accepted: July 29, 2016 Article in press: August 1, 2016 Published online: September 27, 2016 Processing time: 124 Days and 10.9 Hours
Abstract
Eosinophilic gastroenteritis (EGE) is a rare condition characterized by eosinophilic infiltration of the gastrointestinal tract. Depending on the dominant layer of infiltration it is classified into three types namely, mucosal, muscularis and subserosal. The most uncommon variant is the subserosal type characterized by primarily subserosal disease, eosinophilic ascites and peripheral hypereosinophilia. The clinical features are non-specific with history of atopic predisposition and allergy. Endoscopic biopsy is frequently non-diagnostic due to an uninvolved gastrointestinal mucosa rendering its diagnosis a challenge. The mainstay of diagnosis is peripheral hypereosinophilia and eosinophil-rich ascitic fluid on diagnostic paracentesis. Oral steroid therapy is usually the first line of treatment with dramatic response. Due to a propensity for relapse, steroid-sparing therapy should be considered for relapses of EGE. We report a case of subserosal EGE with diagnostic clinical features and treatment response and review the current strategy in the management of eosinophilic ascites.
Core tip: Eosinophilic gastroenteritis (EGE) is a rare condition and the diagnosis of subserosal EGE is challenging due to its nonspecific symptoms and signs and frequently non-diagnostic biopsy on gastrointestinal endoscopy. This review describes a patient with typical findings of peripheral hypereosinophilia and eosinophilic ascites and outlines the current strategy in the diagnosis and treatment of subserosal EGE.
