A Case Report of Eosinophilic Gastroenteritis Diagnosed after an Urgent Laparotomy

Takamasa Matsumoto, Nobutaka Murashima, Takuzo Fujiwara, Shigemichi Iha, Yoshikazu Akura, Keisuke Hamasaki

Department of Surgery, Kurashiki Medical Center

We report a case of eosinophilic gastroenteritis diagnosed correctly after an emergency operation. A 17-year-old man came to our hospital on December 3, 1990, complaining of epigastric pain and right lower abdominal pain of about 2 weeks' duration. The following day ultrasonographic examination demonstrated massive ascitic fluid, and leukocytosis was noted. A diagnosis of peritonitis was made, laparotomy was performed, and 2.1 L of bloody ascitic fluid was found. The peritoneum was only slightly inflamed, and appendectomy was performed. Postoperatively, gastrointestinal symptoms, including nausea, vomiting, abdominal pain and diarrhea persisted, and peripheral eosinophilia and eosinophilic ascites were noted. After other systemic disorders associated with peripheral eosinophilia had been ruled out, pulse steroid therapy was performed, and the symptoms improved dramatically. Histological examination of the resected appendix and colonic biopsy specimens obtained during sigmoidfiberscopy showed massive eosinophilic infiltration leading to a definite diagnosis of eosinophilic gastroenteritis. The patient has been followed up in the outpatient department for 6 years as a very rare case in which relapses occurred every time steroids were stopped.

Key words
eosinophilic gastroenteritis, eosinophilic peritonitis, eosinophilia

Reprint requests
Takamasa Matsumoto Department of Surgery, Kurashiki Medical Center
250 Bakuro-cho, Kurashiki-city, 710 JAPAN

Accepted
May 21, 1997

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