Eosinophilic gastroenteritis in small intestine in a child in a remote medical centre required surgery

Eosinophilic gastroenteritis (EGE) is an extremely rare disease of unknown aetiology that can occur at any age, but rarely in children. It usually presents with ambiguous abdominal pain and the symptoms can occur for years before diagnosis. It needs a high suspicion and therefore misdiagnosis can occur.

We present a case of three-and-a-half year old girl who had a complicated EGE but was misdiagnosed as no proper consult was available as she presented in a remote medical centre. She had 50 cm from her small intestine dissected as micro abscesses and a necrotic mass of 3.5*2.5 cm were observed.

EGE is usually managed medically. However, the patient's condition was complicated and surgery was indicated. However, if proper diagnosis was made, conservative surgery would be the proper management as this case tends to improve with steroids.

Medical centres in remote areas should have a way to discuss atypical cases with a skilled consultant even when urgent as surgery indication can completely differ. This is the first case reported in the region with EGE in a child which can justify the difficulty in diagnosis as it is quite rare and have not been reported previously in the region which can lead to futuristic misdiagnosis.