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Eosinophilic jejunitis presenting as acute abdomen with eosinophilic ascites
  1. Eren Yalçın1,
  2. Hüseyin Döngelli1,
  3. Süleyman Dolu2 and
  4. Mesut Akarsu2
  1. 1 Internal Medicine, Dokuz Eylul Universitesi, Izmir, Turkey
  2. 2 Department Of Gastroenterology, Dokuz Eylul Universitesi, Izmir, Turkey
  1. Correspondence to Dr Hüseyin Döngelli; drhuseyindongelli{at}gmail.com

Abstract

Eosinophilic gastroenteritis (EG) is an inflammatory bowel condition characterised by eosinophilic infiltration of the stomach and small bowel. Smoking and certain foods can trigger EG.

A man in his 40s presented to the emergency department with acute abdominal pain. He had rebound tenderness and guarding on his initial abdominal examination. A subsequent CT scan showed jejunal wall thickening and ascites

He had similar attacks of abdominal pain and was misdiagnosed with familial Mediterranean fever and Crohn’s disease.

Paracentesis revealed eosinophilic ascites. No mucosal abnormality was detected on gastroduodenoscopy and colonoscopy. A double-balloon enteroscopy revealed mucosal inflammation in the jejunum and a biopsy was taken. In this biopsy, eosinophilic jejunitis was detected. He was given corticosteroids and montelukast and his condition was resolved promptly. After discharge, he had attacks of EG until he quit smoking. After quitting smoking, he had an attack once in the last 2 years after consuming eggplant.

  • Endoscopy
  • Crohn's disease
  • Small intestine

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Footnotes

  • Contributors HD, EY, SD, MA were responsible for drafting of the text, sourcing and editing of clinical images, investigation of results, drawing original diagrams and algorithms, and critical revision for important intellectual content. HD, EY, SD, MA gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.