Skip to main content

Advertisement

SpringerLink
Log in

A case of a teenage boy with eosinophilic gastroenteritis with esophageal involvement developing a hemorrhagic duodenal ulcer

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

A boy in his early teens visited our hospital with chief complaints of hematemesis and tarry stools. Upper gastrointestinal endoscopy identified a hemorrhagic duodenal ulcer, for which hemostasis was performed using a clip. Proton pump inhibitor (PPI) administration diminished the ulcer but relapse occurred after PPI discontinuation. The esophagus showed concentric rings and longitudinal linear furrows considered to be characteristic of eosinophilic esophagitis. Biopsies of the duodenal ulcer and the esophagus revealed marked infiltration of eosinophils, leading to a diagnosis of eosinophilic gastroenteritis with esophageal involvement. Steroid treatment was initiated, and the duodenal ulcer and esophagitis resolved. Endoscopic findings characteristic of eosinophilic esophagitis were key to the diagnosis of eosinophilic gastroenteritis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Yan BM, Shaffer EA. Primary eosinophilic disorders of the gastrointestinal tract. Gut. 2009;58:721–32.

    Article  CAS  PubMed  Google Scholar 

  2. Talley NJ, Shorter RG, Phillips SF, et al. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut. 1990;31:54–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Kinoshita Y, Furuta K, Ishimaura N, et al. Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis. J Gastroenterol. 2013;48:333–9.

    Article  PubMed  Google Scholar 

  4. Kaijser R. Zur Kenntnis der allergischen Affektionen des Verdauungskanals vom Standpunkt des Chirurgen aus. Arch Klin Chir. 1937;188:36–64.

    Google Scholar 

  5. Dobbins JW, Sheahan DG, Behar J. Eosinophilic gastroenteritis with esophageal involvement. Gastroenterology. 1977;72:1312–6.

    CAS  PubMed  Google Scholar 

  6. Fujishiro H, Amano Y, Kushiyama Y, et al. Eosinophilic esophagitis investigated by upper gastrointestinal endoscopy in Japanese patients. J Gastroenterol. 2011;46:1142–4.

    Article  PubMed  Google Scholar 

  7. Kinoshita Y, Oshima N, Ishimura N, et al. Diagnosis and treatment of eosinophilic gastrointestinal disorders. Nihon Shokakibyo Gakkai Zasshi. 2013;110:953–64.

    PubMed  Google Scholar 

  8. Klein NC, Hargrove RL, Sleisenger MH, et al. Eosinophilic gastroenteritis. Medicine. 1970;49:299–319.

    Article  CAS  PubMed  Google Scholar 

  9. Méndez-Sánchez N, Chávez-Tapia NC, Vazquez-Elizondo G, et al. Eosinophilic gastroenteritis: a review. Dig Dis Sci. 2007;52:2904–11.

    Article  PubMed  Google Scholar 

  10. Oh HE, Chetty R. Eosinophilic gastroenteritis: a review. J Gastroenterol. 2008;43:741–50.

    Article  PubMed  Google Scholar 

  11. Zhang L, Duan L, Ding S, et al. Eosinophilic gastroenteritis: clinical manifestations and morphological characteristics, a retrospective study of 42 patients. Scand J Gastroenterol. 2011;46:1074–80.

    Article  PubMed  Google Scholar 

  12. Markowitz JE, Russo P, Liacouras CA. Solitary duodenal ulcer: a new presentation of eosinophilic gastroenteritis. Gastrointestinal Endosc. 2000;52:673–6.

    Article  CAS  Google Scholar 

  13. Shimura S, Ishimura N, Tanimura T, et al. Reliability of symptoms and endoscopic findings for diagnosis of esophageal eosinophilia in a Japanese population. Digestion 2014;90:49–57.

    Article  PubMed  Google Scholar 

  14. Desreumaux P, Bloget F, Seguy D, et al. Interleukin 3, granulocyte-macrophage colony stimulating factor, and interleukin 5 in eosinophilic gastroenteritis. Gastroenterology. 1996;110:768–74.

    Article  CAS  PubMed  Google Scholar 

  15. Mishra A, Hogan SP, Lee JJ, et al. Fundamental signals that regulate eosinophil homing to the gastrointestinal tract. J Clin Invest. 1999;103:1719–27.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. de Pineton Chambrun G, Gonzalez F, Canva JY, et al. Natural history of eosinophilic gastroenteritis. Clin Gastroenterol Hepatol. 2011;9:950–6.

    Article  Google Scholar 

  17. Gonsalves N, Yang GY, Doerfler B, et al. Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology. 2012;142:1451–9.

    Article  PubMed  Google Scholar 

  18. Henderson CJ, Abonia JP, King EC, et al. Comparative dietary therapy effectiveness in remission of pediatric eosinophilic esophagitis. J Allergy Clin Immunol. 2012;129:1570–8.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Disclosures

Conflict of Interest: Kenji Yamazaki, et al. declare that they have no conflict of interest.

Human/Animal Rights:All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Infiormed Consent:Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan

    Kenji Yamazaki, Taku Mizutani, Kana Matsuura, Tomohiko Sugiyama, Hiroyuki Sato, Nobuhiro Ando, Keisuke Iwata, Motoaki Imose, Shogo Shimizu, Hiroshi Araki & Junichi Sugihara

  2. Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan

    Tatsuya Sakashita & Atsushi Imamura

  3. Department of Pathology, Gifu Prefectural General Medical Center, Gifu, Japan

    Hitoshi Iwata

Authors
  1. Kenji Yamazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tatsuya Sakashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hitoshi Iwata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Taku Mizutani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kana Matsuura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tomohiko Sugiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroyuki Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nobuhiro Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Keisuke Iwata
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Motoaki Imose
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shogo Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Atsushi Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hiroshi Araki
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Junichi Sugihara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenji Yamazaki.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamazaki, K., Sakashita, T., Iwata, H. et al. A case of a teenage boy with eosinophilic gastroenteritis with esophageal involvement developing a hemorrhagic duodenal ulcer. Clin J Gastroenterol 8, 179–185 (2015). https://doi.org/10.1007/s12328-015-0572-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-015-0572-0

Keywords

Search

Navigation