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Eosinophilic gastroenteritis masquerading as ampullary adenoma
Ravi Madhotra1, Mohamad A Eloubeidi, John T Cunningham
1Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Journal of Clinical Gastroenterology
|March 2, 2002
Summary
Eosinophilic gastroenteritis, a rare gut disorder, can cause pancreaticobiliary obstruction. This case highlights a duodenal mass mimicking an ampullary adenoma, successfully treated with prednisone.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Eosinophilic gastroenteritis is a rare gastrointestinal disorder characterized by eosinophil infiltration of the gut wall.
- Symptoms vary based on the location and depth of intestinal involvement, ranging from abdominal pain to bowel obstruction.
Observation:
- A 39-year-old man presented with abdominal pain, vomiting, abnormal liver tests, and a duodenal mass.
- Peripheral eosinophilia and a suspected ampullary mass were noted on imaging.
- Endoscopic retrograde cholangiopancreatography revealed dilated pancreatic and bile ducts without strictures.
Findings:
- Biopsies confirmed eosinophilic gastroenteritis as the cause of the duodenal mass.
- The mass mimicked an ampullary adenoma, leading to pancreaticobiliary obstruction.
Implications:
- This case underscores the rare presentation of eosinophilic gastroenteritis causing pancreaticobiliary obstruction.
- Prompt diagnosis and corticosteroid treatment (prednisone) led to symptom resolution and normalization of liver tests.