title: Angiotensin-converting enzyme inhibitor-induced angioedema following carotid endarterectomy misdiagnosed as cervical hematoma.
abstract: Angioedema is a localized swelling of sudden onset, often associated with angiotensin-converting enzyme (ACE) inhibitor use, that most commonly occurs in the face and neck. We present the case of a patient on long-term ACE inhibitor therapy for hypertension, who developed postoperative angioedema after carotid endarterectomy (CEA). The patient was initially misdiagnosed with an expanding cervical hematoma and underwent a surgical wound reexploration. Angioedema is a rare cause of neck swelling and upper airway distress occurring after CEA in patients treated with ACE inhibitors and should be considered in the differential diagnosis.
authors.affiliation: Division of Vascular Surgery, San Raffaele Hospital-IRCCS, Vita-Salute University School of Medicine, Milan, Italy. max_marrocco@yahoo.com
authors.forename: Massimiliano M
authors.initials: MM
authors.lastname: Marrocco-Trischitta
authors.forename: Germano
authors.initials: G
authors.lastname: Melissano
authors.forename: Davide
authors.initials: D
authors.lastname: de Dominicis
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiesa
mesh_terms: D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000175:diagnosis*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D002216:Captopril / Q000009:adverse effects; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000601:surgery*; D003951:Diagnostic Errors; D016894:Endarterectomy, Carotid; D046748:Hematoma, Epidural, Spinal / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril