A 30 years old male was admitted to our hospital with the complaints of epigastric
pain, vomitting and swelling of his left limb for the past six days. He was also having
diarrhea for the last several months. He had been evaluated for chronic
diarrhea and
ascites before he sought the current consultation. Duplex color doppler of left limb showed DVT of distal calf vein. Contrast enhanced CT imaging of abdomen revealed thickening of duodenum, proximal jejunal wall and presence of
ascites. Duodenal biopsy showed normal villous pattern with mild
inflammation and eosinophilic infiltration. The constellation of clinical presentation,
hypereosinophilia, CT and biopsy findings all is in consistence to EG. The patient was treated with
prednisolone 20 mg/day for four weeks and tapered slowly.
Acute pancreatitis was managed conservatively while DVT was treated with
heparin and oral
anticoagulants. The patient's
diarrhea settled and
ascites resolved completely. At follow up, the absolute eosinophil count was 300/μl and the patient was doing well.
CONCLUSION: