Pediatric Eosinophilic Gastroenteritis Diagnosed Using Ultrasonography: A Case Report

Abstract

Eosinophilic gastroenteritis is a rare disease. The age of onset varies from children to adults. Mucosa or submucosa thickening is the main cause of eosinophilic gastroenteritis in many cases in Japan; however, its diagnosis is difficult because the site of occurrence is the entire gastrointestinal tract. We herein report the case of an under 6-yerar-old girl who was admitted to our hospital due to abdominal pain, diarrhea, and bloody stools. Ultrasonography revealed thickening of the wall, mainly in the submucosa, from the descending colon to the rectum. Moreover, strong echoes in the wall, suspected as ulcers, could be confirmed during exacerbation. Since an increase in blood eosinophils, appearance of fecal eosinophils, and an increase in IgE were observed, eosinophil gastroenteritis was suspected and prednisolone administration was initiated. Consequently, a definitive diagnosis of eosinophilic gastroenteritis was made from the tissue collected by colonoscopy. Ultrasonography is an important part of the first screening in pediatric abdominal pain patients from the radiation dose viewpoint. Although it never leads to a definitive diagnosis, the main role of ultrasonography is to follow the course while giving attention to the eosinophil level when eosinophilic gastroenteritis is suspected.