Visualization of jejunal bleeding by capsule endoscopy in a case of eosinophilic enteritis.
Eosinophilic enteritis is a rare disease characterized by tissue eosinophilia, which can affect different layers of bowel wall. Normally, the disease presents as colicky abdominal pain, and rarely as an acute intestinal obstruction or perforation. In this paper, we report a case of eosinophilic enteritis, hitherto unreported, presenting as an ileal obstruction, and followed by jejunal bleeding, which was visualized by capsule endoscopy. A 62-year-old man received a 15 cm single segmental ileal resection at a point 50 cm from the IC valve due to symptoms of obstruction, which were diagnosed as eosinophilic enteritis. Seventeen days after operation, intermittent abdominal pain occurred again, and subsided upon 30 mg per day treatment with prednisolone. Fourteen days after this pain attack, the patient exhibited hematochezia, in spite of continuous prednisolone treatment. Capsule endoscopy showed fresh blood spurting from the mid-to-distal jejunum, in the absence of any mass or ulcer. This hematochezia rapidly disappeared following a high-dose steroid injection, suggesting it was a manifestation of jejunal eosinophilic enteritis.
Kim
Nayoung
N
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea. nayoungkim49@empal.com
Kim
Jin-Wook
JW
Hwang
Jin-Hyeok
JH
Lee
Dong Ho
DH
Lee
Hye Seung
HS
Lee
Kyoung Ho
KH
Kim
Sung-Won
SW
D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004751:Enteritis / Q000150:complications*; D004802:Eosinophilia / Q000150:complications*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D007579:Jejunal Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged