Hereditary angioedema (small bowel)
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Approximately 30-40 cm length of mid small bowel at the right abdomen demonstrates smooth, low density mural thickening with abrupt transition to normal bowel thickness. Associated surrounding fat stranding and moderate volume of mesenteric and free intraperitoneal fluid, with fluid tracking into the right inguinal canal. No mechanical obstructing lesion identified. The terminal ileum and adjacent ascending colon are normal. No filling defect within the superior mesenteric artery or vein.
Approximately 30-40 cm length of small bowel mural thickening is nonspecific, and is compatible with angioedema of the small bowel given the clinical history of hereditary angioedema.
Differentials include infectious, inflammatory and less likely ischemic etiologies.
The patient spontaneously recovered although he has had repeated admissions with abdominal pain.