白浜 正文¹, 古賀 貴文¹, 石橋 大海², 内田 哲¹

Masafumi SHIRAHAMA¹, Takafumi KOGA¹, Hiromi ISHIBASHI², Satoshi UCHIDA¹

¹佐賀県立病院好生館内科, ²九州大学第一内科

¹Department of Internal Medicine, Saga Prefectural Hospital, ²The First Department of Internal Medicine, Faculty of Medicine, Kyushu University

キーワード : Ultrasound, Eosinophilic gastroenteritis

Probably the first case report concerning a sonography of eosinophilic gastroenteritis is here reported. A 33-year-old man with abdominal pain, vomiting, and watery diarrhea was admitted to our hospital. He had a history of bronchial asthma over the past 13 years. The laboratory data showed a white blood cell count of 14,100 cells/mm³ with 18% eosinophils. The fecal ova and parasites check proved to be negative. The sonography demonstrated a pronounced thickening of the enteric wall of the ileum. A paracentesis performed under sonographic guidance revealed a profound infiltration of eosinophils in the ascites. A double-contrast barium study of the ileum disclosed a luminal narrowing and edematous Kerckring folds without ulcerations. The ileal biopsy, which showed eosinophilic infiltrations, confirmed the diagnosis of eosinophilic gastroenteritis. His clinical symptoms disappeared soon after the prednisolone therapy was started. Follow-up sonographic and barium study examinations revealed a normalization of the intestinal edema. Sonography proved to be a useful tool for the diagnosis and follw-up study of eosinophilic gastroenteritis.