Eosinophilic Gastroenteritis Causing Small Bowel Diverticulosis and Volvulus: A Case Report

Patient: Female, 83-year-old Final Diagnosis: Eosinophilic gastroentritis • jejunal diverticulosis Symptoms: Abdominal pain • obstruction Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare coexistence of disease or pathology BACKGROUND: Eosinophilic gastroenteritis is a broad classification of disease characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of a stimulatory cause. Given the ability of eosinophilic gastroenteritis to affect the entire gastrointestinal tract, it can present in a variety of ways, from chronic intermittent pain to mechanical obstruction. We present a rare case in which eosinophilic gastroenteritis of the jejunum led to small bowel diverticulosis and volvulus, requiring surgery. CASE REPORT: An 83-year-old woman with a history of chronic abdominal pain, nausea, and early satiety presented to our clinic after a thorough gastrointestinal workup and radiologic diagnosis of partial midgut volvulus. She underwent an exploratory laparotomy and was found to have normal rotational anatomy with prominent small bowel diverticulosis. A section of 70 cm of proximal jejunum was resected, encompassing all visible diverticula, and a primary anastomosis was performed. The patient recovered without complication. She was seen at follow-up with complete resolution of her presenting symptoms. CONCLUSIONS: We propose that this patient’s pathology was caused by chronic intermittent obstructions related to eosinophilic gastroenteritis, leading to repeated periods of increased intraluminal pressure and severe small bowel diverticulosis. This case highlights the importance of maintaining an index of suspicion for small bowel diver-ticulosis in the setting of chronic eosinophilic gastroenteritis.