Transient recurrent ascites.
Angiotensin-converting enzyme (ACE) inhibitors are widely used in heart diseases. We describe a case of a young woman treated with fosinopril. She started experiencing abdominal pain, vomiting and diarrhoea with peritoneal signs on physical examination three years after her treatment has been initiated. She presented ascites and signs of ileitis on imaging studies. She even underwent surgery. The diagnosis of ACE inhibitor-induced angiooedema of the small bowel was made after the fourth episode. Fosinopril was stopped and the symptoms never recurred. The case we describe illustrates clinical presentation, radiological findings and difficulty of making an accurate diagnosis in such a patient.
Kahegeshe
Nsinire L
NL
Department of Gastroenterology and Hepaticopancreatology, Erasme Hospital, University Clinics of Brussels, Free University of Brussels, Brussels, Belgium. nkahegeshe@hotmail.com
Pestiaux
Anne
A
Henry
Jean-Paul
JP
van Cauter
Jacques
J
D015746:Abdominal Pain / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000799:Angioedema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D001201:Ascites / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D017328:Fosinopril / Q000009:adverse effects*; D006801:Humans; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D000806:Angiotensin-Converting Enzyme Inhibitors; D017328:Fosinopril