title: Eosinophilic ascites: A diagnostic and therapeutic challenge.
abstract: Eosinophilic gastroenteritis (EGE) is a rare condition characterized by eosinophilic infiltration of the gastrointestinal tract. Depending on the dominant layer of infiltration it is classified into three types namely, mucosal, muscularis and subserosal. The most uncommon variant is the subserosal type characterized by primarily subserosal disease, eosinophilic ascites and peripheral hypereosinophilia. The clinical features are non-specific with history of atopic predisposition and allergy. Endoscopic biopsy is frequently non-diagnostic due to an uninvolved gastrointestinal mucosa rendering its diagnosis a challenge. The mainstay of diagnosis is peripheral hypereosinophilia and eosinophil-rich ascitic fluid on diagnostic paracentesis. Oral steroid therapy is usually the first line of treatment with dramatic response. Due to a propensity for relapse, steroid-sparing therapy should be considered for relapses of EGE. We report a case of subserosal EGE with diagnostic clinical features and treatment response and review the current strategy in the management of eosinophilic ascites.
authors.affiliation: Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India.
authors.forename: Shefali
authors.initials: S
authors.lastname: Agrawal
authors.affiliation: Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Vohra
authors.affiliation: Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Rawat
authors.affiliation: Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Kashyap
keywords: Atopy; Endoscopic biopsy; Eosinophilia; Eosinophilic ascites; Gastrointestinal