Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4238-4243
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4238
Eosinophilic gastroenteritis with abdominal pain and ascites: A case report
Xiao-Qing Tian, Xiang Chen, Sheng-Liang Chen
Xiao-Qing Tian, Xiang Chen, Sheng-Liang Chen, Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
Author contributions: Tian XQ and Chen X were the patient’s physicians in charge, reviewed the literature and contributed to manuscript drafting; Chen SL reviewed the literature and drafted the manuscript; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Sheng-Liang Chen, MD, PhD, Doctor, Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 145 Middle Shandong Road, Shanghai 200001, China. chenslmd@163.com
Received: January 24, 2021
Peer-review started: January 24, 2021
First decision: March 8, 2021
Revised: March 21, 2021
Accepted: April 9, 2021
Article in press: April 9, 2021
Published online: June 16, 2021
Processing time: 122 Days and 0.9 Hours
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.

Keywords: Eosinophilic gastroenteritis; Abdominal pain; Ascites; Endoscopy; Prednisone; Case report

Core Tip: Eosinophilic gastroenteritis (EGE) is a rare disease that presents many unspecific gastroenterological symptoms. We present a case with abdominal pain, ascites, and eosinophilia after raw and cold seafood. The patient was eventually diagnosed with EGE based on biopsy findings. The case highlights the ultimate importance of multiple point biopsies in diagnosis and the effectiveness of corticosteroid therapy in EGE patients.