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Eosinophilic enteritis with enteroliths: A diagnostic dilemma.

Md Furqan Abdul Waheed1, Girish D Bakhshi1, Zarin Rangwala1

  • 1Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai 400008, India.

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|December 5, 2021
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Summary

Eosinophilic gastroenteritis (EG) is a rare condition causing diagnostic challenges. This case highlights EG presenting as an ileal stricture with enteroliths, emphasizing its varied clinical manifestations.

Keywords:
Abdominal painEnterolithsEosinophilic enteritisIleal stricture

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Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Eosinophilic gastroenteritis (EG) is a rare disorder involving eosinophilic infiltration of the intestinal wall.
  • EG presents with a wide spectrum of symptoms, often leading to diagnostic dilemmas.
  • Obstructive symptoms can occur due to strictures formed by eosinophilic infiltration.

Purpose of the Study:

  • To report a unique case of eosinophilic gastroenteritis presenting as an ileal stricture with enteroliths.
  • To highlight the importance of considering EG in the differential diagnosis of unexplained gastrointestinal issues.

Main Methods:

  • A case study of a 55-year-old female with chronic abdominal pain, constipation, and vomiting.
  • Diagnostic imaging included plain radiographs and contrast-enhanced computed tomography (CECT).
  • Surgical intervention with exploratory laparotomy and resection of the ileal stricture was performed, followed by histopathological analysis.

Main Results:

  • CECT revealed an ileal stricture with dilated proximal loops and enteroliths.
  • Histopathology confirmed eosinophilic gastroenteritis in the resected ileal segment.
  • Enteroliths were found to be composed of dense fecal matter and bile salts.

Conclusions:

  • Eosinophilic gastroenteritis should be considered in the differential diagnosis of gastroenteritis presenting with radio-opaque densities.
  • The presence of enteroliths and strictures can be an unusual manifestation of EG.