Eosinophilic enteritis--a recent north Queensland experience.

Thirty-three patients have been investigated in Townsville between 1983 and 1987 with eosinophilic enteritis. All were Caucasian and had been well prior to this illness. Twenty-six had similar presentations with episodic and transient abdominal pain often with features of small bowel obstruction. Four patients presented with pain and diarrhoea, two with chronic diarrhoea and one with recurrent melena. All patients at some stage during their illness developed high peripheral blood eosinophil counts, mean value 2096/mm3. Nine patients had laparotomies. The disease typically involved a short segment of ileum or jejunum with thickening and induration. The histology of the four resected specimens demonstrated a transmural inflammation with edema and an intense eosinophilic infiltrate. A solitary adult hookworm was identified in one patient adherent to the mucosa of the resected bowel. Each of the 19 patients treated with antihelminthic drugs responded promptly. Recovery was accompanied by a return to normal peripheral blood eosinophil counts. This paper reports an unusual form of eosinophilic enteritis thought due to a parasitic infection. The diagnosis should be considered in patients from North Queensland presenting with abdominal pain and eosinophilia. Laparotomy should be delayed pending a trial of conservative therapy with mebendazole.