Eosinophilic Ascites as a Rare Manifestation of Eosinophilic Gastroenteritis

Eosinophilic gastroenteritis (EGE) is a rare gastrointestinal (GI) disorder characterized by nonspecific gastrointestinal symptoms, peripheral eosinophilia, and eosinophilic infiltration of the intestinal wall. The disorder is classified into mucosal, muscular and sub-serosal types. Sub-serosal disease, which is complicated by ascites, is the most severe clinical form of eosinophilic gastroenteritis and requires early corticosteroid therapy. We report a similar case of a 47 year old male presenting with progressive abdominal distention, who on investigations was found to be having eosinophilic and low Serum Ascites Albumin Gradient (SAAG) ascites, patient was worked up further with upper and lower GI endoscopies and mucosal biopsies, Cross-sectional imaging, Bone marrow examination and finally diagnosed to be having eosinophilic ascites secondary to Eosinophilic Gastrointestinal Disorders (EGIDs). He was started on steroids in a tapering dose with Six Food Elimination Diet (SFED) and improved remarkably. Patient is off steroids now and is planned to continue now on SFED.