Sonography in diagnosis and follow‐up of serosal eosinophilic gastroenteritis treated with corticosteroid

Abstract

An 18-year-old patient presented with abdominal pain, nausea, and low-grade fever. Sonography showed ascites in the region of the terminal ileum, and the presence of peritoneal nodules suggested peritoneal inflammation. Cytologic analysis of ascites revealed numerous eosinophils. Sonographic visualization of nodular peritoneal deposits associated with eosinophilic ascites permitted the diagnosis of the serosal form of eosinophilic gastroenteritis. The absence of mucosal and muscular involvement in the bowel wall was confirmed by endoscopy and CT. Two weeks of 20 mg/day oral prednisolone led to relief of the patient's symptoms, with normalization of laboratory parameters and sonographic findings.

Causes of eosinophilic ascites – A systematic review

“…In addition to the symptoms described above, 29 subjects associated less frequent features like constipation (6) [13,[22][23][24][25][26], bloating (1) [27], skin rash (4) [27][28][29][30], fever (3) [31][32][33], edema (2) [34][35], malabsorption (1) [36], melena (1) [37], even signs of pyloric stenosis (3) [38][39][40], intestinal occlusion or subocclusion(6) [41][42][43][44][45][46], peritonitis secondary to appendicitis (1) [47] and DVT in one patient with acute pancreatitis [48].…”

“…Because of negative biopsy results in the absence of pathological features at abdominal echo, CT scans or endoscopy, in 6 subjects [17][18][50][51][52][53] laparoscopy with peritoneal biopsies provided valuable information to achieve a definite diagnosis. In 3 patients surgery was not performed, and the diagnosis was established according to clinical and biological criteria [33,[54][55].…”

Eosinophilic gastroenteritis: Approach to diagnosis and management

“…Biopsies can be obtained either endoscopically or under ultrasound guidance[27]. Other less invasive parameters may also be useful in monitoring of treatment response, such as reduction in peripheral eosinophilia[5] and improved radiologic aspects[88]. The choice of appropriate follow-up modality should always be individualized.…”

Eosinophilic Gastroenteritis: A Review

“…This sign is considered nonspecific and is observed in other disorders such as lymphoma, Crohn's disease [64], intestinal ischemia, tuberculosis, lymphangiectasia, intramural hematoma, acute appendicitis, and other inflammatory diseases [3]. Although nonspecific, it could be used as a follow-up strategy in selected cases [65]. On computer tomography (CT) scans, thinning of the intestinal walls can be observed (Fig.…”