Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Curr Med Imaging. 2024;20:e15734056258760. doi: 10.2174/0115734056258760231116094613.
Eosinophilic gastroenteritis (EGE) is a rare immune-mediated chronic inflammatory disorder, which is classified into 3 types according to the affected gastric wall layer. The serosal-type EGE is the least common type. Gastric oral contrast-enhanced ultrasonography (OCEUS) may show some specific changes in the serosal-type EGE. Herein, we reported OCEUS findings in a serosal-type EGE case.
A 60-year-old man with unexplained abdominal pain accompanied by diarrhea, which lasted for half a month, consulted the hospital. Laboratory findings revealed peripheral eosinophilia and elevated carbohydrate antigen 125(CA125). OCEUS showed a thickened gastric antrum wall and ascites, with distinct layers (thickening of the muscularis propria layer was most obvious), which is rare and specific. Endoscopy showed normal mucosa of the esophagus and stomach and scattered hyperemia spots in the mucoua of the duodenal bulb and small intestine. Microscopy evaluation revealed few eosinophils infiltration in the lamina propria. A large number of eosinophils were seen in peritoneal lavage fluid and the greater omentum. Eventually, the patient was diagnosed with serosal type EGE.
Significant thickening of the digestive tract walls and ascites at ultrasonography (US)-examination, with distinct layers and predominant thickening of the muscularis propria layer at OCEUS, can indicate EGE.
嗜酸性粒细胞性胃肠炎（EGE）是一种罕见的免疫介导的慢性炎症性疾病，根据受累胃壁层的不同，可分为 3 型。浆膜型 EGE 是最不常见的类型。胃口服超声造影（OCEUS）检查可能显示浆膜型 EGE 的一些特定变化。本文报告了一例浆膜型 EGE 的 OCEUS 检查结果。
一名 60 岁男性，因不明原因腹痛伴腹泻持续半个月就诊。实验室检查发现外周血嗜酸性粒细胞增多和糖抗原 125（CA125）升高。OCEUS 显示胃窦壁增厚和腹水，具有明显的分层（最明显的是固有肌层增厚），这种表现罕见且具有特征性。内镜检查显示食管和胃黏膜正常，十二指肠球部和小肠黏膜散在充血点。显微镜评估显示固有层有少量嗜酸性粒细胞浸润。腹腔灌洗液和大网膜中可见大量嗜酸性粒细胞。最终，患者被诊断为浆膜型 EGE。
超声检查显示消化道壁显著增厚并伴有腹水，OCEUS 显示具有明显的分层，固有肌层增厚为主，这些表现提示 EGE。
