Allergy Asthma Respir Dis.  2016 Sep;4(5):382-385. 10.4168/aard.2016.4.5.382.

Eosinophilic gastroenteritis with intestinal obstruction after ingesting raw yellow tail fish and oyster

• Kim J
• Jang Y
• Shim J
• Yu J
• Lee S
• Kang S
• Lee S

• KMID: 2391930
• DOI: http://doi.org/10.4168/aard.2016.4.5.382

Abstract

Eosinophilic gastroenteritis is a rare disease in which the symptoms are associated with eosinophilic infiltration in various layers of the gastrointestinal tract. A 56-year-old man complained of severe abdominal pain after eating yellow tail fish and oyster. There was no peripheral blood eosinophilia in the initial laboratory test. Abdominal computed tomography demonstrated circumferential wall thickening and dilatation of small intestine with ascites. An emergency laparotomy accompanied by segmental resection of the ileum and end-to-end anastomosis was performed. Histologically, there was a dense infiltration of eosinophils throughout the entire layers of ileal wall, through which this case could be diagnosed as eosinophilic enteritis. We did not prescribe systemic glucocorticosteroid, but asked him to avoid fish and oyster. He did not complain of recurrent gastrointestinal symptoms anymore after discharge. This is the case of eosinophilic gastroenteritis with intestinal obstruction requiring emergency surgery, which was developed or aggravated after ingestion of yellow tail fish and oyster that were suspected to be culprit foods. In patients with eosinophilic gastroenteritis, foods which are related to this abnormal condition should be identified and avoided to control this disease and prevent from aggravation or flare-up.

Keyword

Eosinophilic gastroenteritis; Food allergy; Intestinal obstruction

MeSH Terms

Abdominal Pain
Ascites
Dilatation
Eating
Emergencies
Enteritis
Eosinophilia
Eosinophils*
Food Hypersensitivity
Gastroenteritis*
Gastrointestinal Tract
Humans
Ileum
Intestinal Obstruction*
Intestine, Small
Laparotomy
Middle Aged
Ostreidae*
Rare Diseases
Tail*

Figure

• 

  Fig. 1 Abdominal X-ray showed multiple air-fluid level in the small intestine.

• 

  Fig. 2 Abdominopelvic computed tomography scans showed circumferential wall thickening and dilatation of small intestine.

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  Fig. 3 Histopathologicalogic examination yielded dense infiltration of eosinophils (200/high power field) throughout entire layers of ileum. (A) Mucosal and submucosal layer (H&E, ×200), (B) muscular layer (H&E, ×400), and (C) serosal and subserosal layer (H&E, ×400).

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