Eosinophilic Gastroenteritis Accompanied with Partial Midgut Malrotation in an Adult: A Case Report.

BACKGROUND Eosinophilic gastroenteritis (EGE) is a rare inflammatory condition characterized by eosinophilic infiltration of the gastrointestinal tract, often presenting with non-specific symptoms such as abdominal pain, diarrhea, and ascites. Midgut malrotation is a congenital anatomical anomaly typically diagnosed in infancy but may remain undetected until adulthood. The coexistence of EGE and partial midgut malrotation in an adult is extremely rare and has not been previously reported. CASE REPORT We report the case of a 25-year-old man who presented with persistent epigastric cramping pain and abdominal distension. Laboratory evaluation revealed marked eosinophilia, elevated C-reactive protein, and high total IgE levels. Abdominal contrast-enhanced CT showed duodenal wall thickening, mucosal edema, and abnormal positioning of the horizontal duodenum and proximal jejunum, suggestive of partial midgut malrotation. Endoscopy revealed congested, swollen mucosa with patchy erosions and narrowing at the duodenal bulb-descending junction. Histopathology confirmed eosinophilic infiltration in the duodenal and gastric mucosa. The patient was diagnosed with eosinophilic gastroenteritis accompanied by partial midgut malrotation. He was treated with corticosteroids and supportive care, resulting in significant clinical and hematologic improvement. CONCLUSIONS This case highlights a rare but important diagnostic consideration involving the coexistence of inflammatory and congenital anatomical gastrointestinal disorders. Clinicians should maintain a high level of suspicion for structural anomalies in adults presenting with unexplained gastrointestinal symptoms. Early multidisciplinary evaluation is essential for accurate diagnosis and appropriate management.