CT imaging features of eosinophilic colitis in children.
BACKGROUND
Eosinophilic colitis (EC) is a gastrointestinal disease of undetermined etiology whose clinical features overlap with those of the inflammatory bowel diseases. To the best of our knowledge, the CT imaging features of EC have not been described in children.


OBJECTIVE
To report and analyze the clinical, imaging and histological findings in seven children with EC.


METHODS
Children with EC were identified in a pediatric pathology database, and those with CT imaging within 2 months of diagnosis were included, totaling seven children. Clinical, imaging and pathological features were reviewed and analyzed.


RESULTS
The most common presenting symptoms were abdominal pain, bloody diarrhea and rectal bleeding. EC was characterized as a dense and predominantly eosinophilic inflammatory infiltrate in the lamina propria or epithelium without granulomas. CT scans were abnormal in six children (86%), demonstrating colonic wall thickening, predominantly cecal, in five (71%), mild to moderate terminal ileal thickening in two (29%), and pneumatosis in one (14%). Right colonic involvement was greater than terminal ileal involvement.


CONCLUSIONS
CT imaging findings in children with EC include right colonic wall thickening of variable extent downstream and absent or mild involvement of the terminal ileum. EC should be considered in the differential diagnosis in children presenting with abdominal pain and bloody diarrhea.
Department of Radiology, Children's Hospital Colorado, 13123 E. 16th Ave., Aurora, CO 80045, USA. jonbra@gmail.com
Jonathan L
JL
Brandon
Shauna
S
Schroeder
Glenn T
GT
Furuta
Kelley
K
Capocelli
Joanne C
JC
Masterson
Laura Z
LZ
Fenton
D002648:Child; D002675:Child, Preschool; D003092:Colitis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004751:Enteritis / Q000000981:diagnostic imaging*; D004802:Eosinophilia / Q000000981:diagnostic imaging*; D005260:Female; D005756:Gastritis / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*