title: Gastrointestinal manifestations of hereditary angioedema diagnosed by ultrasound in the emergency department.
abstract: Abdominal angioedema is a less recognized type of angioedema, which can occur in patients with hereditary angioedema (HAE). The clinical signs may range from subtle, diffuse abdominal pain and nausea, to overt peritonitis. We describe two cases of abdominal angioedema in patients with known HAE that were diagnosed in the emergency department by point-of-care (POC) ultrasound. In each case, the patient presented with isolated abdominal complaints and no signs of oropharyngeal edema. Findings on POC ultrasound included intraperitoneal free fluid and bowel wall edema. Both patients recovered uneventfully after receiving treatment. Because it can be performed rapidly, requires no ionizing radiation, and can rule out alternative diagnoses, POC ultrasound holds promise as a valuable tool in the evaluation and management of patients with HAE.
authors.affiliation: Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California.
authors.forename: Christine
authors.initials: C
authors.lastname: Riguzzi
authors.affiliation: Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California.
authors.forename: Lia
authors.initials: L
authors.lastname: Losonczy
authors.affiliation: UCSF School of Medicine, Department of Emergency Medicine, San Francisco, California.
authors.forename: Nathan
authors.initials: N
authors.lastname: Teismann
authors.affiliation: Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Herring
authors.affiliation: Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California.
authors.forename: Arun
authors.initials: A
authors.lastname: Nagdev
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D000293:Adolescent; D054179:Angioedemas, Hereditary / Q000150:complications / Q000000981:diagnostic imaging*; D050718:Complement C1 Inhibitor Protein / Q000378:metabolism*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000000981:diagnostic imaging* / Q000209:etiology; D010808:Physical Examination; D019095:Point-of-Care Systems; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D050718:Complement C1 Inhibitor Protein