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A 53-year-old white man complained of massive abdominal swelling of 10 days duration. He gave a 20-year history of atopy, epigastric burning, and cramping abdominal pain. Peripheral eosinophilia (4420/mm3), exudative ascites, with 99% eosinophils; compatible endoscopic and contrast x-ray findings; and typical findings on small bowel peroral biopsy made the diagnosis of eosinophilic gastroenteritis with ascites. The clinical features and laboratory findings of our case are compared to the 14 cases found in reviewing the English literature. Therapy with corticosteroids resulted in resolution of both the gastrointestinal symptoms and the ascites within a 4-week period.