A case report of eosinophilic jejunal enteritis with spared stomach presenting as abdominal pain

Abstract

Eosinophilic gastroenteritis (EoGE) is a group of infrequent conditions that arise from the accumulation of eosinophils in the gastrointestinal (GI) tract without any secondary causes of eosinophilia. Most cases of EoGE cases show involvement of different parts of the GI tract. Herein, we report a case of EoGE with the sole involvement of Jejunum. A 57-year-old male patient presented to our center with a chief complaint of acute abdominal pain. The patient had experienced chronic abdominal pain and intermittent diarrhea for several years, but he presented to the emergency department with severe acute flank pain. The patient was first diagnosed with renal stone and treated accordingly. However, the computed tomography (CT) scan also showed other incidental findings related to his chronic abdominal pain from several years ago, including mesenteric infiltration which shows fluid appearance in some areas, mild wall thickening, and mucosal edema of the duodenum and jejunal loops with normal appearance of the ileum. Complete blood count (CBC) showed increased eosinophil (15.5%) and decreased lymphocytes (13.1%) percent. Pathological examination of enteroscopy samples of jejunum showed a mild increase in the number of eosinophils in lamina propria. Neither parasites nor granuloma was detected. However, no such changes were found in other parts of the GI tracts. Based on pathological examination, the patient was diagnosed with eosinophilic enteritis of the jejunum. EoGE does not typically involve a specific part of the GI and generally affects both the stomach and intestine. This study reported the first case of EoGE where only the jejunal part of the intestine was involved and other parts of the GI tract were spared.

Keywords

• Eosinophilic gastroenteritis
• Jejunal enteritis
• Eosinophilia
• Chronic abdominal pain
• Computed tomography scan
• Mesenteric infiltration