Waheed Md Furqan Abdul, Bakhshi Girish D, Rangwala Zarin, Patel Owais Ahmed, Mohan Aishwarya, Jain Urvashi
Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai 400008, India.
Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai 400008, India.
Int J Surg Case Rep. 2021 Dec;89:106571. doi: 10.1016/j.ijscr.2021.106571. Epub 2021 Nov 3.
Eosinophilic gastroenteritis (EG) is a rare disease, characterized by eosinophilic infiltration of different layers of intestinal wall. Thus having a wide spectrum of presentation leading to diagnostic dilemma.
We report a case of 55 years old female who presented with pain in abdomen, constipation, vomiting off and on with passage of stools on alternate days since 6 months. Plain radiographs showed radio-opaque densities in abdomen. Contrast enhanced computed tomography (CECT) of abdomen showed Ileal stricture with dilated proximal bowel loops with enteroliths. Exploratory laparotomy confirmed ileal stricture with thickening of the mesentery and an ileal diverticulum. Resection of ileal stricture was performed. The resected segment contained seven hard, black enteroliths. Histopathology of the resected specimen confirmed EG. Stone analysis showed dense faecal matter with bile salts.
EG leads to symptoms ranging from vomiting, abdominal pain, diarrhoea, blood loss in stools, anaemia to malabsorption resulting in diagnostic dilemma. It may cause gastrointestinal obstructive symptoms secondary to stricture, depending upon the predominant layer involved.
The differential diagnosis of EG should always be considered when dealing with gastroenteritis presenting with radio-opaque densities in abdomen.
嗜酸性粒细胞性胃肠炎（EG）是一种罕见疾病，其特征为肠壁不同层出现嗜酸性粒细胞浸润。因此，其临床表现多样，导致诊断困难。
我们报告一例55岁女性患者，自6个月以来间断出现腹痛、便秘、呕吐，隔天排便。腹部平片显示腹部有不透X线的密度影。腹部增强计算机断层扫描（CECT）显示回肠狭窄，近端肠袢扩张并伴有肠石。剖腹探查术证实为回肠狭窄，肠系膜增厚，并有一个回肠憩室。进行了回肠狭窄切除术。切除的肠段包含七颗坚硬的黑色肠石。切除标本的组织病理学证实为EG。结石分析显示含有胆汁盐的致密粪便物质。
EG可导致从呕吐、腹痛、腹泻、便血、贫血到吸收不良等一系列症状，从而造成诊断困难。根据受累的主要肠壁层，它可能导致因狭窄引起的胃肠道梗阻症状。
在处理腹部出现不透X线密度影的胃肠炎时，应始终考虑EG的鉴别诊断。
