title: Possible angiotensin-converting enzyme inhibitor (ACEI)-induced small bowel angioedema.
abstract: OBJECTIVE
  To report a case of possible lisinopril-induced angioedema of the small bowel.
  
  
  METHODS
  A 67-year-old female was admitted to the hospital with abdominal pain, nausea, vomiting, and diarrhea. A computed tomography (CT) scan of the abdomen/pelvis was obtained which showed wall thickening around the area of the jejunum and scant ascites consistent with several diagnoses, including small bowel angioedema. She was treated with intravenous fluids and nasogastric decompression. Stool studies were negative. Her lisinopril was held due to the possibility of small bowel angioedema. A CT enterography obtained 5 days after the discontinuation of lisinopril showed complete resolution of the inflammatory changes and perihepatic fluid. It was felt that angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema of the small bowel was the most likely etiology of her symptoms.
  
  
  CONCLUSIONS
  Angiotensin-converting enzyme inhibitor small bowel angioedema is an uncommon cause of abdominal symptoms. In several cases, patients had been taking ACEIs for years before symptoms occur. Treatment includes cessation of the ACEI and supportive care.
  
  
  CONCLUSIONS
  Angiotensin-converting enzyme inhibitor-related small bowel angioedema should be considered in the differential diagnosis of unexplained abdominal pain.
authors.affiliation: Iowa Methodist Medical Center, Des Moines, IA, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Haines
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Wall
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000000981:diagnostic imaging; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D007421:Intestine, Small; D017706:Lisinopril / Q000009:adverse effects*; D009325:Nausea / Q000139:chemically induced; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D017706:Lisinopril