Shetty Spoorthy Sudhakar, Shetty Charan Kishor
Department of Surgery, Faculty of Medicine and Health Sciences, UCSI University, Bukit Kor, PT 11065, Mukim Rusila, 21600 Marang, Terengganu, Malaysia.
Department of Forensic Medicine, Faculty of Medicine, Universiti Sultan Zainal Abidin (Unisza), Kampus Kota, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu, Malaysia.
Case Rep Surg. 2015;2015:691904. doi: 10.1155/2015/691904. Epub 2015 Apr 16.
Eosinophilic enteritis is a rare disorder presenting mostly with diarrhea, malabsorption, abdominal pain, weight loss, and hypersensitivity. Surgical manifestation of eosinophilic gastrointestinal disorders depends on the site and extent of involvement. In our case series of four patients two of them had ileocaecal masses with recurrent subacute intestinal obstruction with past history of intake of antitubercular drugs for 9 months. On histopathological examination both of them proved to have eosinophilic enterocolitis. Thus it is a clinical dilemma to differentiate between these two conditions. The other two patients presented as acute abdomen with perforation and intussusception. All four patients were treated surgically. Postoperatively they recovered well with no symptoms on one year follow-up. In Indian setup tuberculosis being rampant there may be under reporting or wrongly diagnosed cases of eosinophilic enteritis. Thus a strong clinical suspicion and awareness of this clinical entity are essential among surgical community.
嗜酸性粒细胞性肠炎是一种罕见疾病,主要表现为腹泻、吸收不良、腹痛、体重减轻和过敏。嗜酸性粒细胞性胃肠道疾病的手术表现取决于受累部位和范围。在我们的4例患者病例系列中,其中2例有回盲部肿块,伴有复发性亚急性肠梗阻,既往有9个月的抗结核药物服用史。经组织病理学检查,两人均被证实患有嗜酸性粒细胞性小肠结肠炎。因此,区分这两种情况是一个临床难题。另外2例患者表现为急性腹痛伴穿孔和肠套叠。所有4例患者均接受了手术治疗。术后恢复良好,1年随访无任何症状。在印度,结核病猖獗,可能存在嗜酸性粒细胞性肠炎报告不足或误诊的情况。因此,外科界必须对此临床实体有强烈的临床怀疑和认识。