A case of eosinophilic gastroenteritis of the predominant subserosal layer

Abstract

We report a case of eosinophilic gastroenteritis of predominant subserosal layer.
The laboratory data revealed eosinophilic-predominant leukocytosis of 30% or more, and massive ascites was noted.
Because ileus symptoms did not improve, we performed emergency operation without making the correct preoperative diagnosis. During the operation, thickened small bowel wall with stenosis on the ileum end was confirmed, and we performed ileocolectomy including the ileum by 40cm in length on the oral side of the ieocecal valve.
Histopathologically diffuse infiltration of eosinophils was recognized in the subserosal layer predominantly, and it was diagnosed as eosinophilc gastroenteritis. Thus steroid therapy was started, and symptomatic remission was attained. Fortunately, postoperative complications such as anastomotic leakage did not occur in our case.
However, it must be remembered that we could not save the patient after severe complications once occur following thoughtless laparotomy without the clear recognition of eosinophilic gastroenteritis.
It is important not only to bear this disorder in mind in diagnosing any gastrointestinal diseases but also to recognize the difference in the symptoms and the examination data among 4 subtype categories.