Patients often present with nonspecific findings of abdominal pain, nausea, and vomiting.
There are three main types of intestinal angioedema:
- hereditary deficiency of C1 inhibitor enzyme
- acquired deficiency of C1 inhibitor enzyme (associated with B-cell lymphoproliferative disorders and autoimmune disease)
- angiotensin-converting enzyme inhibitors (ACEi) 3
- calcium channel blockers 4
The exact mechanism of angioedema in the bowel is not completely understood, but it is thought to involve bradykinin pathways and subsequent vasodilation (instead of histamine pathways).
- long segment concentric thickening of the bowel submucosa
- jejunum more often affected
- mild mesenteric oedema
- no obstruction
- no lymphadenopathy
- 1. Scheirey CD, Scholz FJ, Shortsleeve MJ et-al. Angiotensin-converting enzyme inhibitor-induced small-bowel angioedema: clinical and imaging findings in 20 patients. AJR Am J Roentgenol. 2011;197 (2): 393-8. doi:10.2214/AJR.10.4451 - Pubmed citation
- 2. Vallurupalli K, Coakley KJ. MDCT features of angiotensin-converting enzyme inhibitor-induced visceral angioedema. AJR Am J Roentgenol. 2011;196 (4): W405-11. doi:10.2214/AJR.10.4856 - Pubmed citation
- 3. Jacobs RL, Hoberman LJ, Goldstein HM. Angioedema of the small bowel caused by an angiotensin-converting enzyme inhibitor. Am. J. Gastroenterol. 1994;89 (1): 127-8. Pubmed citation
- 4. Turcu AF, White JA, Kulaga ME et-al. Calcium channel blocker-associated small bowel angioedema. J. Clin. Gastroenterol. 2009;43 (4): 338-41. doi:10.1097/MCG.0b013e31815cf6b9 - Pubmed citation