But the diagnosis of EG was suspected because of peripheral eosinophilia and chronic gastrointestinal symptoms. The histologic examination of mucosa showed intense tissue eosinophila that confirmed the diagnosis. The clinical presentation in this case is suggestive of both mucosal and muscle layer disease. The three prior episodes of acute pancreatitis that were unexplained in past were most likely due to pancreatic obstruction due to eosininophilic gastroenteritis involving the papilla. It is conceivable that the disease at the time was limited only to muscle layer of gut wall and hence it wasn't picked up on biopsies.
Elimination diet are occasionally successful but relapses are common.
In conclusion, this case illustrates the wide variety of gastrointestinal manifestations due to this disease and emphasizes the importance of clinical suspicion and diagnostic utility of endoscopic biopsies. Idiopathic eosinophilic infilteration of the gastrointestinal tract, diffuse and circumscribed. A clinicopathological study of patients with disease of mucosa, muscle layer, and subserosal tissues. Deposition of eosinophil granule major basic protein in eosinophilic gastroenteritis and celiac disease. Eosinophilic gastroenteritis - A complex disease entity.