Enterolithiasis complicating eosinophilic enteritis: A case report and review of literature

Abstract

We report a case of eosinophilic enteritis involving the proximal small bowel, a relatively rare entity, presenting unusually as enteroliths in a 68-year-old man with complaints of anemia, malena and abdominal pain. The disease if diagnosed in the initial stages responds well to medical treatment but if associated with complications or misdiagnosed, surgical modality is the treatment of choice. In our case, the patient presented with enteroliths and strictures. Resection and anastomosis of the small bowel containing stones was carried out. Histopathology confirmed the diagnosis as eosinophilic enteritis.

Unusual case of subacute intestinal obstruction due to eosinophilic enteritis with enteroliths

“…The serosal involvement occurs only in a minority of the patients and is characterized by exudative ascites with higher peripheral eosinophilic counts as compared to other forms. [2,4,5,7] D'souza, et al: Intestinal obstruction due to eosinophilic enteritis CT scan may show nodular and irregular thickening of the foregut which may mimic other conditions like Crohns disease, tuberculosis or lymphoma. Since either layer of the GI tract can be involved, endoscopic biopsy can be normal in patients with the muscularis subtype, serosal subtype, or both.…”

“…[2,5,6] The symptoms depend on the site of infiltration and the layers affected. [1,4] Eosinophilic enteritis can be asymptomatic or symptomatic. The clinical presentations of eosinophilic enteritis depend on the level of involvement.…”

“…[4] These disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, and eosinophilic colitis and are occurring with increasing frequency. [4] Eosinophilic gastritis, enteritis and gastroenteritis are grouped together because they are clinically similar and there is a paucity of information available concerning their pathogenesis. However, it is likely that they are indeed distinct entities in most patients.…”

“…[1] About 85% of cases are associated with eosinophilia. [2,4] Eosinophilic gastrointestinal (GI) disorders may be primary or secondary in nature. Primary eosinophilic GI disorders are defined as disorders that selectively affect the GI tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia (e.g.…”

“…These diseases are characterized by the selective infiltration of eosinophils in the stomach, small intestine, or both, with variable involvement of the esophagus, large intestine, or both. [4] Eosinophilic intestinal inflammation can occur secondarily in the GI tract in inflammatory bowel disease, autoimmune diseases, reactions to medications, infections, hypereosinophilic syndrome and after solid organ transplantation. [5] Eosinophilic recruitement into the inflammatory tissue is thought to be a complex process regulated by IL-3, IL-5 and granulocyte macrophage colony stimulating factor (GM-CSF).…”