Abstract
A 28-year-old male patient presented with chronic pain abdomen in the right iliac fossa, intermittent vomiting and frequent defecation. Trans-abdominal ultrasonography and CT abdomen pelvis revealed long segment diffuse circumferential wall thickening of distal ileum, caecum and adjacent ascending colon. Colonoscopy revealed ulcers in the ileo-caecal valve with terminal ileal stricture. Blood eosinophilia, tuberculosis and parasitic infections were excluded. A diagnosis of enterocolitis was suspected. Brush biopsy could confirm the rare diagnosis of an eosinophilic enterocolitis with predominantly mucosal and sub-mucosal infiltration. The patient was started on corticosteroids. Six months later the patient relapsed with symptoms and signs of intestinal obstruction. Repeat ultrasonography showed the persistent bowel wall thickening. Colonoscopy showed stenosed and deformed ileo-caecal valve with chronic ulceration. Diagnosing Primary Enterocolitis is based on colonic biopsies, which is especially challenging in the absence of diagnostic criteria. It is necessary to eliminate secondary causes by ultrasonography/ CT abdomen pelvis. CT/MR imaging provides valuable information for diagnosis, guiding treatment and assessing response to therapy.
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