Highlights
- •Angiotensin-converting enzyme inhibitors can cause angioedema of the small bowel.
- •The diagnosis is often made by radiologists because clinical signs are non-specific.
- •T2-weighted MRI facilitates recognition of submucosal edema in affected bowel.
- •Findings of ascites and mucosal/serosal bowel enhancement are also evident on MRI.
- •The condition resolves upon discontinuation of the offending medication.
Abstract
Angioedema is a condition in which an increase in vascular permeability leads to the
swelling of body tissues. There are both hereditary and acquired forms of the disease,
with the latter often associated with the administration of angiotensin-converting
enzyme inhibitor medication. Involvement of the intestinal tract is a rare manifestation
of angioedema, and can present with abdominal pain, nausea, and vomiting. It is critical
for radiologists to be aware of this entity, as they may have the only opportunity
to make the diagnosis. We present three cases of intestinal angioedema diagnosed on
MRI with discussion of the imaging findings.
Keywords
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References
- Multicenter study of patients with angiotensin-converting enzyme inhibitor-induced angioedema who present to the emergency department.Ann Allergy Asthma Immunol. 2008; 100: 327-332
- The pathophysiology of hereditary angioedema.Clin Immunol. 2005; 114: 3-9
- Angiotensin converting enzyme inhibitor induced angio-oedema: A review of the pathophysiology and risk factors.Clin Exp Allergy. 2010; 40: 50-61
- Angiotensin converting enzyme inhibitor-related angioedema: onset, presentation, and management.Ann Otol Rhinol Laryngol. 2015; 124: 89-96
- Meta-analysis of randomized trials of angioedema as an adverse event of renin–angiotensin system inhibitors.Am J Cardiol. 2012; 110: 383-391
- Intermittent visceral edema induced by long-term enalapril administration.Ann Pharmacother. 2004; 38: 825-827
- Angiotensin-converting enzyme inhibitor–induced small-bowel angioedema: Clinical and imaging findings in 20 patients.American Journal of Radiology. 2011; 197: 393-398
- Angioedema associated with lisinopril.Am J Emerg Med. 1992; 10: 321-322
- MDCT features of angiotensin-converting enzyme inhibitor–induced visceral angioedema.American Journal of Radiology. 2011; 196: 405-411
- Age-related differences in presentation and course of inflammatory bowel disease: An update on the population-based literature.J Crohn's Colitis. 2014; 8: 1351-1361
- Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review.Gastroenterology. 2012; 142: 46-54
- Diagnosis please case 127: Henoch Schonlein purpura.Radiology. 2007; 245: 909-913
Article info
Publication history
Published online: March 08, 2017
Accepted:
March 6,
2017
Received in revised form:
January 9,
2017
Received:
August 30,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
