Endoscopy Challenge #2 - Jan '10

Discussion

Eosinophilic gastritis as an etiology of gastric outlet obstruction has been described in infants, children and adults1-5. Attempts at therapy have ranged from hydrolysate formula to corticosteroids and even surgical resection1-5. A history of atopy or peripheral eosinophilia is not necessarily present, thus a high index of suspicion may be needed to avoid unnecessary surgical intervention. Endoscopically, eosinophilic gastric outlet obstruction may have an appearance similar to that of infantile hypertrophic pyloric stenosis6, and pinch biopsies may assist in diagnosis when necessary.

Charina Ramirez, MD
Fellow, University of Texas Southwestern
Children's Medical Center, Dallas

Brad Barth, MD
University of Texas Southwestern
Children's Medical Center, Dallas

Diagnosis

References