Eosinophilic gastroenteritis (EGE) with eosinophilic ascites is a rare disease that can present with abdominal pain and can be challenging for a clinician to differentiate amidst the numerous causes of abdominal pain with ascites. Due to the non-specificity of symptoms and scarcity of diagnostic guidelines, a high index of suspicion is required to diagnose EGE and thereby defer unnecessary surgical interventions. Herein, we present the case of a middle aged female who had presented to the Gastroenterology department with severe abdominal pain and her basic blood test showed hypereosinophilia mimicking an acute abdomen. The relevance of the case resides in highlighting the fact that such rare diseases are often missed and a broader diagnostic spectrum should be considered while evaluating cases of undifferentiated acute abdomen. The clue for the diagnosis may be hidden in the basic lab reports.
