JOP. J Pancreas (Online) 2006; 7(2):211-217. JOP. Journal of the Pancreas - http://www.joplink.net - Vol. 7, No. 2 - March 2006. [ISSN 1590-8577] 211 CASE REPORT Recurrent Acute Pancreatitis Due to Eosinophilic Gastroenteritis. Case Report and Literature Review Stig Lyngbaek 1 , Sven Adamsen 2 , Antonio Aru 3 , Magnus Bergenfeldt 2 Departments of 1 Anaestesiology, 2 Gastrointestinal Surgery, and 3 Pathology, Copenhagen University Hospital Herlev. Copenhagen, Denmark ABSTRACT Context Eosinophilic gastroenteritis is characterized by eosinophilic infiltration of any gastrointestinal segment from the esophagus to the rectum, most commonly, the stomach and the duodenum. Clinical manifestations range from non-specific gastrointestinal complaints to more specific symptoms such as protein-losing enteropathy, malabsorption, luminal obstruction and eosinophilic ascites. Case report We report the case of a 35-year- old woman with recurrent gastric outlet obstruction due to eosinophilic infiltration of the stomach and the duodenum. There was a history of two episodes of acute pancreatitis as well as eosinophilia of bone marrow and ascites. Conclusions Although unusual, eosinophilic gastroenteritis may be complicated by symptomatic acute pancreatitis. Seven previous cases have been reported in the literature, and a comparison was made. The pancreatitis is probably due to duct obstruction, but some cases of eosinophilic gastroenteritis have pancreatic tissue eosinophilia. Most cases respond to medical treatment, and surgery is usually unnecessary. INTRODUCTION Eosinophilic gastroenteritis (EGE) was initially described by Kaijser in 1937 [1], and several hundred cases have since been reported. Eosinophilic cells can accumulate in any part of the gastrointestinal tract from the esophagus to the rectum; the most commonly affected are the stomach and the duodenum [2, 3, 4]. According to the classification by Klein, three different disease patterns of EGE can be discerned: mucosal, submucosal and serosal, although more than one layer may be involved [2, 5]. The clinical manifestations depend on which wall layer and which bowel segments are predominantly involved. Thus, mucosal disease may result in anemia, protein-losing enteropathy, and malabsorpt- ion, whereas muscle layer infiltration typically causes luminal obstruction [2, 4, 5]. The rarest form is serosal disease with eosinophilic ascites [2, 4]. However, many of the clinical manifestations are non-specific, such as nausea, vomiting, crampy abdominal pain, and diarrhea, thus making a diagnosis may be difficult [2, 4]. This paper reports a case of EGE causing recurrent acute pancreatitis which is an extremely unusual complication. A survey of the literature reveals only seven reported cases [6, 7, 8, 9, 10, 11, 12]. The association