Eosinophilic myenteric ganglionitis is a rare cause of pseudo-obstructive intestinal syndrome, predominantly reported in children. It is characterized by symptoms that mimic mechanical intestinal obstruction, despite the absence of a demonstrable lesion, and is identified histologically by an eosinophilic myenteric inflammatory process. We report the case of a male newborn presenting with intestinal obstruction found to have intestinal malrotation and histological evidence of colonic wall ganglion cells surrounded by a moderate eosinophilic infiltrate. The patient underwent surgical correction with a protective diverting ileostomy, resulting in progressive clinical improvement. At 18 months of age, follow-up with a contrast enema revealed persistent old contrast medium in the dysfunctional sigmoid rectum, suggesting possible rectal motility impairment. This is the first reported case in the literature of a newborn with intestinal malrotation in the presence of eosinophilic myenteric ganglionitis. The need for comprehensive intestinal wall biopsy for accurate diagnosis is emphasized, highlighting the importance of early diagnosis for proper management and complication prevention. This case underscores the necessity for further research to enhance understanding, diagnosis, and treatment of eosinophilic myenteric ganglionitis.
Sua et al. (Tue,) studied this question.