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Eosinophilic Gastroenteritis with Ascites in a Young Male Patient—A Case Report

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Abstract

Background

Eosinophilic gastroenteritis (EGE) is an uncommon condition defined by the presence of gastrointestinal symptoms in conjunction with an abnormal accumulation of eosinophils within the intestinal wall. The disease can manifest with varied symptoms depending on the depth of infiltration into the bowel wall. EGE accompanied by ascites is a rare occurrence mostly associated with the subserosal type. This case highlights a rare presentation of subserosal EGE manifesting with eosinophilic ascites, emphasizing the diagnostic challenges and the importance of considering this entity in patients with unexplained ascites and gastrointestinal symptoms. Further, it emphasizes the recognition and management of subserosal EGE and thereby expands the current understanding of its clinical spectrum.

Case Presentation

A 20-year-old male presented with diarrhea, vomiting, abdominal pain, and dyspeptic symptoms for a 3-week duration. He had a leucocytosis of 22,990 cells/mm3 with significant eosinophilia (14,570 cells/mm3, 64.3%) and a normal serum IgE level (89 IU/mL). A contrast-enhanced CT of the abdomen and pelvis revealed edematous thickening of the bowel wall with moderate ascites. Diagnostic paracentesis confirmed the presence of high eosinophils. Significant eosinophilic infiltration was identified in biopsies taken from the ileum during endoscopy. Parasitic infections, other possible systemic diseases, and bone marrow pathologies were excluded. EGE was suspected, and daily prednisolone 20 mg was started. After 7 days of treatment, a significant improvement in symptoms was noted, with eosinophil count returning to normal values.

Conclusion

This case highlights the importance of considering eosinophilic gastroenteritis in patients who present with gastrointestinal symptoms and ascites associated with peripheral blood eosinophilia, as most patients respond well to steroids, resulting in better patient outcomes.

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Data Availability

No datasets were generated or analysed during the current study.

Code Availability

Not applicable.

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Acknowledgements

We extend our acknowledgment to the patient who was in our care.

Author information

Authors and Affiliations

  1. Colombo South Teaching Hospital, Colombo, Sri Lanka

    Gayashani Jayasinghe, Cherine Sosai, Mananjala Senanayake & Shehan Silva

  2. Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo, Sri Lanka

    Shehan Silva

Contributions

1. GJ—Being a internal medicine trainee was involved in the management of the patient and drafted the manuscript. wrote the main manuscript and involved in patient management. 2. CS- As the consultant histopathologist, was involved in the diagnosis and management of the patient. Also reviewed the manuscript. 3. MS- As the consultant gastroenterologist was involved in the diagnosis and management of the patient. Also reviewed the manuscript. 4. SS—Was the primary consultant under whom the patient was admitted. He was involved in the management at all steps along with GJ and provided supervision and guidance to write/review the main manuscript.

Corresponding author

Correspondence to Gayashani Jayasinghe.

Ethics declarations

Ethics Approval

Not applicable.

Consent to Participate

Not applicable as this was not an interventional study but rather a case report.

Written Consent for Publication

Written informed consent was obtained from the patient for publication of this case report and accompanying images.

Competing interests

The authors declare no competing interests.

Additional information

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Cite this article

Jayasinghe, G., Sosai, C., Senanayake, M. et al. Eosinophilic Gastroenteritis with Ascites in a Young Male Patient—A Case Report. SN Compr. Clin. Med. 7, 211 (2025). https://doi.org/10.1007/s42399-025-01986-1

  • Received
  • Revised
  • Accepted
  • Published
  • DOI https://doi.org/10.1007/s42399-025-01986-1

Keywords

  • Eosinophilia
  • Eosinophilic gastroenteritis
  • Eosinophilic ascites
  • Case report

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