This patient presented with severe abdominal pain, and had concern of ischemia from the first CT and proceeded to exploratory surgery with negative results. The patient's pain continued for more than a month before repeating the imaging with worsening inflammation, prompting the suggested diagnosis of ACE-inhibitor-related angioedema. After this suggestion, the medication was stopped and the patient's symptoms rapidly improved, with resolution of bowel wall thickening at the final follow-up scan.