Eosinophilic gastroenteritis presenting as acute small intestinal obstruction: A case report
Bharani Rajkumar, Sasivannan Anbarasu, Muthuvel Essaki, Aruna Padmavathy.
Eosinophilic gastroenteritis (EGE) is a rare disease of unknown etiology. It is characterized by eosinophilic infiltration of bowel wall to a variable extent and is associated with variable gastrointestinal (GI) symptoms. We elucidate here a case of eosinophilic gastroenteritis presenting as a small bowel obstruction in the post-operative period after groin surgery. A 66-year-old man was admitted in this hospital for bilateral direct inguinal hernia and bilateral hernioplasty was done. On the 7th post-operative day, he developed abdominal distension, abdominal pain, obstipation and vomiting. His abdomen was distended with diffuse tenderness and there was no guarding or rigidity. Abdominal radiograph revealed multiple air-fluid levels in small intestine. CT abdomen was taken which confirmed the distal small bowel obstruction and presence of ascites. An emergency laparotomy was performed and an area of induration in the ileum about 50 cm proximal to the ileo-cecal junction was noted. A segmental iliectomy was performed and primary end to end anastomosis was done. Histologically there was a dense transmural infiltration of eosinophils so, eosinophilic enteritis was diagnosed. The patient recovered well. The present report has been made for the rarity of the lesion and its unusual presentation.
Key words: Eosinophilic Enteritis; Small Bowel Obstruction; Eosinophilic Infiltration; Steroid Therapy