Eosinophilic gastroenteritis with involvement of the urinary bladder
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Published on: June 24, 2025
Hai Chun Zhou1, Can Lai, Li Yang
1Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, People's Republic of China.
Insights
Eosinophilic gastroenteritis, a rare condition, can affect the urinary bladder in children. Recognizing CT imaging features is crucial for early diagnosis and treatment of this gastrointestinal and bladder disease.
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.
Abstract:
Eosinophilic gastroenteritis with eosinophilic infiltration of the urinary bladder wall is rare in children. We describe the CT findings of eosinophilic gastroenteritis accompanied by bladder involvement in an 11-year-old boy. CT imaging showed diffuse wall thickening of the entire gastrointestinal tract from the esophagus to the colon and revealed a halo sign, irregular fold thickening and luminal narrowing without obstruction of the gastrointestinal wall. Another CT finding was the diffuse thickening of the bladder wall with moderate enhancement on postcontrast CT. The boy underwent endoscopic biopsy from various sites of the gut wall and histology revealed increased eosinophiliac infiltration in the mucosa. After corticosteroid therapy, the boy recovered gradually. The case emphasizes that not only the gastrointestinal tract but also the urinary bladder may be involved in children with eosinophilic gastroenteritis and that recognition of CT features of this disease aids in early diagnosis and therapy.
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