A rare case of eosinophilic gastrointestinal disorders with short bowel syndrome after strangulated bowel obstruction

Abstract

Background Short bowel syndrome (SBS) is a rare yet costly disease with an incidence rate of 3 per million people. Herein, we report a rare case of eosinophilic gastrointestinal disorders (EGIDs) with SBS after strangulated bowel obstruction. Case presentation A 5-year-old male had a necrotic intestine of 340 cm resected due to strangulated bowel obstruction caused by an intestinal mesenteric hiatal hernia. The length of the residual intestine was 51 cm. Bloody stools appeared 19 days postoperatively. Colonoscopy showed diffuse redness of the colonic mucosa, and pathological findings showed moderate chronic inflammatory cellular infiltration. On blood examination, the eosinophil count was > 30%. EGIDs with short bowel syndrome (SBS) were suspected. Because his symptoms did not improve with initial nutrition therapy, he was transferred to our hospital 5 months after the operation. Prednisolone was administrated at an initial dose of 1.4 mg/kg/day, 6 days after his transfer. Bloody stools disappeared after prednisolone administration. Seven months after discharge, he had no bloody stool recurrence. Conclusion The risk of developing secondary EGIDs in children with SBS should be considered, and postoperative management should include attention to abdominal symptoms and elevated eosinophil counts on blood examination.

Impact of Dietary Protein on the Management of Pediatric Short Bowel Syndrome

“…Although complex proteins may be superior in stimulating adaptation [ 9 ], infants with SBS may have increased bowel permeability and harbor a trend toward the development of food allergies. An association between non-infectious eosinophilic colitis and pediatric SBS has been reported and may support that hypothesis [ 10 ].…”

“…Although complex proteins may be superior in stimulating adaptation [9], infants with SBS may have increased bowel permeability and harbor a trend toward the development of food allergies. An association between non-infectious eosinophilic colitis and pediatric SBS has been reported and may support that hypothesis [10]. Therefore, when breast milk is not available, current evidence supports the use of amino acid formulas (AAFs) or extensively hydrolyzed formulas (EHFs; protein size of less than 1500 Daltons) as enteral feeding sources.…”