Diagnosis of small bowel obstruction secondary to eosinophilic enteritis using nasointestinal ileus tube and enteroscopy: a case report.

BACKGROUND

Eosinophilic enteritis presenting primarily with small bowel obstruction is challenging to diagnose. This article reports a case of eosinophilic enteritis localized in the upper ileum, manifesting as low small bowel obstruction, which was confirmed by nasointestinal ileus tube combined with enteroscopy. CASE PRESENTATION: A 52-year-old female was admitted due to intermittent generalized abdominal colic. Physical examination revealed periumbilical tenderness. Abdominal CT showed segmental small bowel wall thickening, luminal stenosis with mucosal enhancement. Painless balloon enteroscopy detected localized ileitis with one stenosis. Biopsy pathology showed massive eosinophilic infiltration in the lamina propria, confirming the diagnosis of eosinophilic enteritis. The patient's symptoms improved significantly after glucocorticoid treatment, and no recurrence was observed during the 12-month follow-up period.

CONCLUSIONS

This case suggests that for patients with small bowel obstruction, eosinophilic enteritis should be considered even if the peripheral blood eosinophil count is normal. Enteroscopic biopsy is the key method for diagnosing eosinophilic enteritis, and nasointestinal ileus tube can relieve intestinal obstruction to create favorable conditions for enteroscopy.