Eosinophilic Myenteric Ganglionitis Presenting as Sigmoid Volvulus: A Brief Report

Area of Science:

• Gastroenterology
• Pathology

Background:

• Eosinophilic myenteric ganglionitis (EMG) is a rare condition affecting the Auerbach myenteric plexus, primarily observed in pediatric patients.
• It leads to chronic intestinal pseudo-obstruction (CIPO) due to eosinophilic infiltration and obliteration of the myenteric plexus.

Observation:

• This report details a unique case of EMG diagnosed in a 73-year-old male presenting with severe constipation and obstipation.
• The patient's condition was initially attributed to sigmoid volvulus following orthopedic surgery and opioid use.

Findings:

• Diagnostic confirmation of EMG was established through surgical pathology after an exploratory laparotomy and Hartmann's procedure.
• The diagnosis of EMG in an adult challenges typical clinical presentations and diagnostic approaches.

Implications:

• This case underscores the importance of considering EMG in adult patients with CIPO, even though it's predominantly a pediatric diagnosis.
• The findings suggest a need for further research into the potential for EMG in adult populations and its diagnostic challenges.
• Management strategies for adult EMG may require re-evaluation, moving beyond current pediatric-focused treatment paradigms.