Intestinal angioedema

Intestinal angioedema is oedema into the submucosal space of the bowel wall following protein extravasation from "leaky" vessels. It can affect both the small and large bowel.

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)
  • medications
    • 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).

CT
  • long segment concentric thickening of the bowel submucosa
  • mild mesenteric oedema
  • no obstruction
  • no lymphadenopathy
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Article Information

rID: 37571
Section: Pathology
Synonyms or Alternate Spellings:
  • Small bowel angioedema
  • Colon angioedema

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Cases and Figures

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    Case 1: hereditary angioedema
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