14-year-old case of boy diagnosed of eosinophilic gastroenteritis that gastric cancer was doubted in an image.

Abstract

A 14-year-old boy presented with stomachache and nausea. Blood tests showed eosinophilia (WBC 9200/microl, Eos 29.0%) and increase in ECP (Eosinophil Cationic Protein). Computed tomography revealed wall thickening ranging from pylorus to jejunum, and scirrhous gastric cancer was initially suspected. Endoscopic and histological study showed mucosal redness and edema with eosinophilic infiltration, which led to a diagnosis of eosinophilic gastroenteritis.After oral prednisolone (1 mg/kg per day) was started, eosinophlia and ECP were soon improved, but gastric outlet obstruction remained. Methylprednisolone pulse therapy (30 mg/kg per day, 3 days) was started, then he gained appetite.
Gastric outlet obstruction is a rare complication of eosinophilic gastroenteritis, most commonly treated surgically. We report a case of eosinophilic gastric outlet obstruction in a child that responded to conservative medical management.