Department of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Department of Surgery, Greenslopes Private Hospital, Brisbane, Queensland, Australia
BMJ Case Rep. 2021 May 10;14(5):e240101. doi: 10.1136/bcr-2020-240101.
A 59-year-old woman was referred to a specialist gastroenterologist following a year of intermittent abdominal bloating and worsening reflux. In the month prior to referral, the patient developed intermittent large volume vomiting consisting of bile-stained undigested food. This was accompanied by a 10 kg weight loss. Imaging and endoscopic investigations showed a circumferential thickening of the second part of the duodenum. Biopsy showed non-specific inflammatory changes with marked eosinophilic infiltrates. A pancreaticoduodenectomy was performed. Histopathological analysis of the resection sample showed primary eosinophilic duodenitis with no evidence of malignancy. Immunological testing was only positive for coeliac disease and an infectious cause was never identified. The patient's symptoms resolved following the surgery and she was discharged from surgical follow-up after 8 years of no further symptoms.
一位 59 岁女性因间歇性腹胀和反流加重，在一年后被转介给一位胃肠病学专家。在转诊前的一个月，患者出现间歇性大量呕吐，吐出含有未消化食物的胆汁。同时，她的体重减轻了 10 公斤。影像学和内镜检查显示十二指肠第二段环状增厚。活检显示非特异性炎症改变，伴有明显的嗜酸性粒细胞浸润。行胰十二指肠切除术。切除标本的组织病理学分析显示原发性嗜酸性粒细胞性十二指肠炎，无恶性证据。免疫检查仅为乳糜泻阳性，从未发现感染原因。手术后，患者的症状得到缓解，8 年后无进一步症状，她从外科随访中出院。
