緊急手術を施行した好酸球性腸炎の1例

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  • A Case of Eosinophilic Enteritis Requiring Emergency Surgery

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A 38-year-old man who ate raw ray liver reported right lower abdominal pain 2 days later, evidencing tenderness and rebound tenderness in the right lower quadrant of the abdomen. Laboratory data indicated elevated WBC (15, 200/mm3) and CRP (9.48mg/dl), and marked acidosis (base excess -7.4mmol/L). Abdominal computed tomography showed thickening of the ascending colon and small intestinal wall, and fluid collection around the ascending colon. Under a diagnosis of idiopathic peritonitis, we conducted emergency surgery, finding induration about 5cm in diameter in the ascending colon and in the ileum, necessitating partial resection of the ileum and colon. Pathological findings confirmed transmural infiltration of inflammatory cells mainly composed of eosinophilic leukocytosis at both colon and ileum induration. Because no paracites was found in the specimen and postoperative laboratory data indicated eosinophilia (9.0%), the definitive diagnosis was eosinophilic enteritis.

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