Eosinophilic gastroenteritis with involvement of the urinary bladder

Area of Science:

• Pediatric Gastroenterology
• Medical Imaging
• Histopathology

Background:

• Eosinophilic gastroenteritis (EG) is a rare gastrointestinal disorder characterized by eosinophilic infiltration of the gut wall.
• Urinary bladder involvement in EG is exceptionally uncommon, particularly in pediatric cases.
• Accurate diagnosis relies on a combination of clinical presentation, imaging, and biopsy.

Observation:

• This case report details the computed tomography (CT) findings in an 11-year-old boy with EG and concurrent bladder wall thickening.
• CT revealed diffuse gastrointestinal wall thickening (esophagus to colon) with a halo sign, irregular folds, and luminal narrowing.
• Postcontrast CT demonstrated diffuse bladder wall thickening with moderate enhancement.

Findings:

• Histopathological examination of endoscopic biopsies confirmed significant eosinophilic infiltration of the gastrointestinal mucosa.
• The imaging findings correlated with the diagnosis of eosinophilic gastroenteritis extending to the urinary bladder.
• Corticosteroid therapy led to gradual clinical improvement.

Implications:

• This case highlights the potential for urinary bladder involvement in pediatric eosinophilic gastroenteritis, expanding the known spectrum of the disease.
• Familiarity with the characteristic CT features of EG, including extragastrointestinal manifestations like bladder thickening, is essential for timely diagnosis.
• Early recognition and appropriate treatment, such as corticosteroid therapy, can lead to favorable outcomes in affected children.