PMC3533628_01
Computed tomography of abdomen and pelvis showing large amount of ascites and thickened small bowel wall. No pelvis or peritoneal mass identified.
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Computed tomography of the abdomen and pelvis showed large volume ascites and prominent small bowel loops (Figures 1(a) and 1(b)).
Esophagogastroduodenoscopy showed multiple areas of erythematous patches at the duodenal bulb.
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Oesophagogastroduodenoscopy (Figure 2) showed multiple areas of erythematous patches at the superior duodenal angle close to the second portion of the duodenum.
H&E Low power view of second part of duodenal biopsy showing Marsh 3a villous atrophy.
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Histological examination of duodenal mucosa revealed Marsh 3a villous atrophy consistent with coeliac disease although no previous biopsies were available for comparison (Figure 3).
H&E high power view of jejunal biopsy showed increase in lamina propria cellularity with eosinophilic infiltration.
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Jejunal mucosa showed dense infiltration of eosinophils on the lamina propria (30/HPF) (Figures 4 and 5).
H&E section of jejunal biopsy showed eosinophils infiltration (30/HPF) in the lamina propria.
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Jejunal mucosa showed dense infiltration of eosinophils on the lamina propria (30/HPF) (Figures 4 and 5).
Computed tomography showing resolution of ascites and small bowel thickening three months after discharge from hospital.
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A repeat computed tomography of the abdomen and pelvis three months after discharge from hospital showed resolution of the ascites and small bowel wall thickening (Figures 6(a) and 6(b)).