Obscure gastrointestinal bleeding as first symptom of eosinophilic jejunitis in a liver transplant recipient: diagnosis and treatment with single balloon enteroscopy

Abstract

The small bowel is only partially accessible to traditional endoscopic techniques. The recently introduced push-and-pull enteroscopy technique allows endoscopists to examine the small bowel in its entirety and enables them to take biopsy specimens and administer treatment. We report the case of a liver transplant recipient presenting with obscure gastrointestinal bleeding, whose diagnosis of eosinophilic enteritis was achieved following a single balloon enteroscopy examination. The patient was discharged 3 days after endoscopic treatment. Eosinophilic enteritis is still not a well known disease. The modality of treatment was suggested by our endoscopic experience and not from codified guidelines. The patient's haemoglobin value was normal 12 months after treatment.

Role of balloon enteroscopy for obscure gastrointestinal bleeding in those with surgically altered anatomy: A systematic review

“…Following the search of these databases, 14 studies in total were included in our review. Of these studies, 6 were retrospective studies[ 7 - 12 ], 2 were prospective studies[ 13 , 14 ], 1 was a case series[ 15 ], and the remaining 5 were case reports[ 16 - 20 ]. In total, there were 68 procedures performed with 61 unique patients that had undergone these procedures.…”

Eosinophilic Enteritis Flare-Up Mimicking Acute Gastroenteritis: A Rare Case

“…The term “eosinophilic enteritis” was first introduced by Kaijser in 1937 and has often been used interchangeably with eosinophilic gastroenteritis in literature, as the nomenclature is under review. It is defined by the presence of GI symptoms associated with eosinophil-rich infiltration of the intestinal mucosa, without secondary intestinal eosinophilia [ 2 ]. The exact epidemiology of EE is unknown, as there have been less than 400 cases reported in the literature.…”

“…Eosinophilic gastrointestinal (GI) disorders constitute a heterogeneous group of rare diseases, including eosinophilic esophagitis, gastritis, enteritis, gastroenteritis, and colitis [ 1 ]. In 1937, Kaijser first defined the term “eosinophilic enteritis” (EE) by its association with GI symptoms and eosinophil-rich infiltration of the intestinal mucosa, without secondary intestinal eosinophilia [ 2 ]. After eosinophilic esophagitis, both eosinophilic gastroenteritis and EE represent the most frequent subset of disorders [ 3 ].…”