Non-esophageal eosinophilic gastrointestinal disorder (non-EoE EGID) is a group of immune-mediated gastrointestinal diseases characterized by infiltration of eosinophils. Although most patients experience symptom relief after treatment, some still face the risk of persistent symptoms or relapse. Improving the prognosis for this subset of patients remains an urgent challenge. Identifying risk factors that affect the prognosis of non-EoE EGID and providing timely effective interventions are crucial for improving outcomes. This paper reviews the risk factors related to the prognosis of pediatric non-EoE EGID, including genetic factors, allergies, environmental factors, clinical characteristics, endoscopic findings, and pathological manifestations, with the aim of providing references for clinical decision-making.
Humans ; Prognosis ; Risk Factors ; Child ; Eosinophilia/etiology* ; Gastritis/etiology* ; Enteritis/etiology*

A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.
Abdominal Pain/etiology* ; Ascitic Fluid ; Enteritis ; Eosinophilia/etiology* ; Gastritis ; Humans ; Male

Chronic enteritis can produce an excess of reactive oxygen species resulting in cellular damage. Stanniocalcin-1(STC-1) reportedly possesses anti-oxidative activity, the aim of this study was to define more clearly the direct contribution of STC-1 to anti-oxidative stress in cattle. In this study, primary intestinal epithelial cells (IECs) were exposed to hydrogen peroxide (H2O2) for different time intervals to mimic chronic enteritis-induced cellular damage. Prior to treatment with 200 microM H2O2, the cells were transfected with a recombinant plasmid for 48 h to over-express STC-1. Acridine orange/ethidium bromide (AO/EB) double staining and trypan blue exclusion assays were then performed to measure cell viability and apoptosis of the cells, respectively. The expression of STC-1 and apoptosis-related proteins in the cells was monitored by real-time PCR and Western blotting. The results indicated that both STC-1 mRNA and protein expression levels positively correlated with the duration of H2O2 treatment. H2O2 damaged the bovine IECs in a time-dependent manner, and this effect was attenuated by STC-1 over-expression. Furthermore, over-expression of STC-1 up-regulated Bcl-2 protein expression and slightly down-regulated caspase-3 production in the damaged cells. Findings from this study suggested that STC-1 plays a protective role in intestinal cells through an antioxidant mechanism.
Animals ; Animals, Newborn ; Blotting, Western/veterinary ; Caspase 3/*genetics/metabolism ; Cattle ; Cattle Diseases/etiology/*genetics/metabolism ; Duodenum/metabolism ; Enteritis/etiology/genetics/metabolism/*veterinary ; Epithelial Cells/metabolism ; *Gene Expression Regulation ; Glycoproteins/*genetics/metabolism ; Hydrogen Peroxide/pharmacology ; Male ; Proto-Oncogene Proteins c-bcl-2/*genetics/metabolism ; RNA, Messenger/genetics/metabolism ; Real-Time Polymerase Chain Reaction/veterinary

Eosinophilic gastroenteritis (EGE) is a rare disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, especially the stomach and duodenum. EGE has vague, nonspecific symptoms, including nausea, vomiting, abdominal pain, diarrhea, weight loss, ascites, and malabsorption. Here, we report a patient with EGE presenting with concurrent acute pancreatitis and ascites. A 68-year-old woman was admitted with abdominal pain, nausea, vomiting, and watery diarrhea. Laboratory findings revealed elevated serum titers of amylase, lipase, and peripheral blood eosinophil count. An abdominopelvic computed tomography scan showed a normal pancreas, moderate amount of ascites, and duodenal thickening. A esophagogastroduodenoscopy showed patchy erythematous mucosal lesions in the 2nd portion of the duodenum. Biopsies from the duodenum indicated eosinophilic infiltration in the lamina propria. The patient was successfully treated with prednisolone and montelukast. Despite its unusual occurrence, EGE may be considered in the differential diagnosis of unexplained acute pancreatitis, especially in a patient with duodenal edema on imaging or peripheral eosinophilia.
Acute Disease ; Aged ; Ascites/*etiology ; Enteritis/*complications ; Eosinophilia/*complications ; Female ; Gastritis/*complications ; Humans ; Pancreatitis/*etiology ; Tomography, X-Ray Computed

OBJECTIVETo investigate the effect of preoperative nutritional support in the management of patients with chronic radiation enteritis (CRE) with intestinal obstruction undergoing resectional surgery.

METHODSClinical data of 158 CRE patients undergoing diseased bowel resection from 2001 to 2011 were analyzed retrospectively. A total of 130 patients received preoperative nutritional support, including 28 patients with enteral nutrition support, 60 patients with total parenteral nutrition support, and 42 patients with combined nutritional support. The nutritional parameters, procedures, operation-related complications, and postoperative hospital stay were recorded.

RESULTSAfter aggressive nutritional support in 130 patients, patients nutritional index, such as serum prealbumin, transferrin, serum albumin improved significantly preoperatively, while the change of body mass index and hemoglobin was not significant. Compared to those without preoperative nutritional support, those who received preoperative nutritional support had lower stoma rate (31.5% vs. 53.6%, P=0.027), less postoperative infection rate (13.8% vs. 32.1%, P=0.019), shorter postoperative hospital stay [(14.1±7.3) d vs. (18.8±15.8) d, P=0.013). Enteral nutrition group had less postoperative infection rate (7.1% vs. 21.7%, P=0.017), lower stoma rate (28.6% vs. 48.3%, P=0.02), and shorter postoperative hospital stay [(15.5±9.6) d vs. (21.7±19.0) d, P=0.025) as compared to total parenteral nutrition group.

CONCLUSIONSPreoperative nutritional support can decrease the stoma rate, postoperative infection rate, and shorten hospital stay in CRE patients complicated with intestinal obstruction. If tolerated, enteral nutrition support should be chosen.

Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Enteritis ; etiology ; surgery ; Female ; Humans ; Intestinal Obstruction ; complications ; surgery ; Male ; Middle Aged ; Nutritional Support ; methods ; Preoperative Care ; Radiation Injuries ; complications ; Retrospective Studies ; Treatment Outcome ; Young Adult

Cytomegalovirus (CMV) infections are usually diagnosed in immunocompromised patients. A 74-year-old male without any significant medical history visited our center because of abdominal pain and diarrhea which began about a month ago. Abdominal computed tomography revealed segmental enhanced bowel wall thickening on jejunum and single-balloon enteroscopy showed multiple geographic shaped ulcerations covered with exudates on proximal jejunum. Biopsy samples taken during endoscopic examination demonstrated necrotic fibrinopurulent tissue debris and benign ulcer. Nested-PCR analysis of CMV DNA from jejunal tissue was positive. The patient was finally diagnosed with CMV jejunitis and was treated by intravenous ganciclovir for 14 days after which, abdominal pain and diarrhea improved. Our case shows that CMV jejunitis can occur in an immunocompetent adult as multiple jejunal ulcers which can be diagnosed using a single-balloon enteroscope.
Aged ; Antiviral Agents/therapeutic use ; Cytomegalovirus/genetics/isolation & purification ; Cytomegalovirus Infections/complications/*diagnosis/drug therapy ; DNA, Viral/analysis ; Endoscopy, Gastrointestinal ; Enteritis/*diagnosis/etiology/virology ; Ganciclovir/therapeutic use ; Humans ; Injections, Intravenous ; Jejunal Diseases/*diagnosis/etiology/virology ; Male ; Polymerase Chain Reaction ; Tomography, X-Ray Computed

Ischemic enteritis is caused by either the interruption or significant reduction of arterial inflow to the small intestine. Risk factors are old age, diabetes mellitus and cardiovascular disease. It is very rare in young patients. We experienced a 21-year-old man with recurrent acute ischemic enteritis who was diagnosed with capsule endoscopy. He had previously taken medications for pulmonary hypertension and obstruction of both carotid arteries, and about 20 months earlier, he had been admitted due to hematochezia. Two sessions of angiography did not reveal the cause of hematochezia. At that time, capsule endoscopy showed mucosal edema and erythema in the terminal ileum, suggesting healed ischemic enteritis. The patient was admitted again due to hematochezia. Abdominal computed tomography showed focal celiac trunk stenosis and diffuse wall thickening of the small intestine, suggesting ischemic enteritis. Capsule endoscopy showed multiple active ulcers and severe hemorrhage with exudate, extending from the proximal jejunum to the terminal ileum. Using capsule endoscopy, the patient was diagnosed with acute extensive ischemic enteritis. Because endoscopic images of ischemic enteritis have rarely been reported, we report a case of a 21-year-old man who was diagnosed acute extensive ischemic enteritis with capsule endoscopy.
Angiography ; Capsule Endoscopy ; Enteritis/complications/*diagnosis/radiography ; Gastrointestinal Hemorrhage/etiology ; Humans ; Intestine, Small/pathology ; Male ; Tomography, X-Ray Computed ; Young Adult

Ascites ; etiology ; Child, Preschool ; Enteritis ; complications ; Eosinophilia ; complications ; Female ; Gastritis ; complications ; Humans ; Recurrence

Faltering linear growth is commonly encountered in children with intestinal inflammation. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) are important regulators of postnatal longitudinal bone growth. Inhibition of GH/IGF axis will result in growth failure in young children. Pro-inflammatory cytokines such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) abnormally increase in children with intestinal inflammation, and may affect linear growth both systemically and locally at the level of the growth plate though disturbing the GH/IGF axis.
Bone Development ; Cytokines ; physiology ; Enteritis ; complications ; Growth Disorders ; etiology ; Human Growth Hormone ; physiology ; Humans ; Somatomedins ; physiology

OBJECTIVETo analyse the clinical features, diagnostic methods and risk factors of cytomegalovirus (CMV) enteritis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSAnalysis was made on 24 cases of CMV enteritis after allo-HSCT in Beijing Daopei Hospital from Aug. 2007 to Jul. 2009, including clinical data, endoscopic diagnosis, histopathological and virological results, and the association between CMV enteritis with viremia and graft-versus-host disease(GVHD).

RESULTS87.5% of the patients were over 18 years old. The median time to diagnosis of CMV enteritis was 63 days after HSCT. The mucosal lesions in enteroscopic examination had no significant differences between CMV enteritis and gastrointestinal GVHD complicated with the enteritis. The methods used in diagnosis included histopathology (32.1%) and virology (92.9%). The copies of CMVDNA in mucosal samples greater than 10(5)/10(6) PBNC was better diagnosis. A number of risk factors were compared between the survival and death groups: type of transplant, conditioning regimen, the time span of ganciclovir prophylaxis therapy, grade II-IV GVHD before enteritis, the time of diagnosis as GVHD, using MP > or = 1 mg/kg to treat GVHD, the time between GVHD and enteritis, CMV viremia before enteritis, the time of diagnosis as enteritis, CMVDNA quantitation, and there were no any statistic differences.

CONCLUSIONCytomegalovirus enteritis should be carefully diagnosed by histopathology and virology through endoscopic examination. It is better to undertake pan-colon endoscopy as well as terminal ileum examination for more accurate diagnosis. PCR can significantly improve the detection rate. CMVDNA detection in patients' stool may be helpful to diagnosis, especially for those patients who can not stand the endoscopy examination.

Adolescent ; Adult ; Cytomegalovirus ; Cytomegalovirus Infections ; etiology ; DNA, Viral ; isolation & purification ; Enteritis ; etiology ; virology ; Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Risk Factors ; Young Adult