Eosinophilic Infiltration of the Stomach

It is the purpose of this paper to present an additional example of a rare disease, eosinophilic infiltration of the stomach. This we believe is the first case to be reported in which a provisional diagnosis was made radiographically and subsequently confirmed by surgical excision and pathological examination. The clinical and radiographic findings are so similar to those in previously reported cases that awareness of the condition may permit a definitive diagnosis. Literature In 1937, Kaijser (1) reported 3 cases illustrating the importance of allergic diseases of the bowel to the surgeon. His first case followed neoarsphenamine therapy for syphilis. Ten days after treatment the patient experienced abdominal colic, vomiting, and meteorism. The second case was similar, with symptoms of nausea, abdominal pain, and vomiting nineteen days after administration of neoarsphenamine. Both these patients were shown at surgery to have peritoneal effusions; the small bowel was red, swollen, and edematous. These findings were interpreted as representing an allergic bowel reaction to neoarsphenamine. Kaijser's third patient, with an allergic family background, experienced pain and vomiting after eating onions. Nine days following a gastrectomy for ulcer he was shown to have a 25 per cent eosinophilia. In 1947, Sison, Dionisio, Silva, and Chavez (2) reported the case of a 31-year-old female with recurring episodes of acute abdominal pain and leukocytosis with eosinophilia. She also had ascites, with eosinophils in the peritoneal fluid. Each of four attacks was associated with pregnancy. Herrera and de la Guardia (3), in 1948, published a case of pyloric tumor with multiple tumors along the small bowel, associated with postoperative eosinophilia of 20 per cent. Barrie and Anderson (4), also in 1948, described a 27-year-old female with a two-weeks history of abdominal pain and vomiting. One previous attack, four years earlier, was associated with melena. This patient had a prepyloric filling defect on the greater curvature of the stomach. Eosinophilia ranged from 18 to 31 per cent three weeks after partial gastrectomy. The pathological details are included in the report. Vanek (5), in 1949, and Polayes and Krieger (6), in 1950, described eosinophilic granulomas of the stomach and jejunum in which there was either no elevation of blood eosinophils or, at the most, a 3 per cent increase. An extensive report of a case of eosinophilic infiltration of the stomach and bowel associated with pyloric obstruction and recurrent eosinophilia was presented by Spencer, Comfort, and Dahlin (7) in 1950. Their patient was a physician with a history of epigastric and lower abdominal cramps with diarrhea and vomiting in periodic attacks over a twelve-year period. The eosinophilia in this case reached as high as 45 per cent. The next case, reported by Booher and Grant (8), in 1951, was similar to Vanek's.