| Abstrakt: |
Eosinophilic gastroenteritis consists histologically of a purely eosinophilic infiltration of small bowel and stomach walls. This is manifested radiologically in the small bowel as a thickening of the circular folds and wall without mucosal ulceration or any other local abnormality, either over much of its length or in a shorter segment. Many of the other causes of pure fold and wall thickening can be excluded by correlation with the clinical presentation so that this condition, although rare, should in the right clinical setting be considered by the radiologist. The typical clinical features consist of cramps, diarrhoea, distension, nausea and vomiting, either as a single subacute episode or with an intermittent history going back months or years, and frequently in a patient with a personal or family history of asthma or other allergic disorders. The eosinophilic infiltration may spare the mucosa in which case per-oral biopsy methods would give negative results. The only means of proving the diagnosis would then be by laparotomy to obtain a full thickness biopsy. However the radiological and clinical features, combined with a therapeutic trial of corticosteroids which rapidly reduce the clinical, radiological and haematological abnormalities, may be sufficient to avert this. The two cases described illustrate many of these features but in addition, unlike most other published cases, they showed neither radiologically visible gastric involvement nor peripheral blood eosinophilia. |
