title: Isolated Intestinal Angioedema in the Emergency Department.
abstract: BACKGROUND
  Angioedema is a condition that can cause cutaneous and mucosal edema of practically any part of the body. Isolated edema of the intestines is a rather rare manifestation, but it can cause important morbidity. Hereditary angioedema as well as certain medications can give rise to intestinal angioedema. We have seen a rise in frequency of intestinal angioedema since the advent of angiotensin-converting enzyme inhibitors. Ultrasound of the abdomen is an inexpensive, safe, and easy tool that can help in the differential diagnosis.
  
  
  METHODS
  We describe the case of a 25-year-old woman who presented with acute abdominal pain. She was diagnosed with intestinal angioedema due to hereditary angioedema type I. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Misdiagnosis can lead to administering the wrong treatment or even unnecessary surgical interventions. Intestinal angioedema is best treated with purified C1-inhibitor, icatibant, or ecallantide. Fresh frozen plasma is to be avoided because it carries the risk of worsening the symptoms.
authors.affiliation: Department of Internal Medicine, University Hospital Brussels, Brussels, Belgium.
authors.forename: Jamal
authors.initials: J
authors.lastname: Belkhouribchia
authors.affiliation: Department of Radiology, University Hospital Brussels, Brussels, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Backaert
authors.affiliation: Department of Emergency Medicine, University Hospital Brussels, Brussels, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Neyrinck
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D054179:Angioedemas, Hereditary / Q000175:diagnosis* / Q000188:drug therapy; D003174:Complement C1 Inactivator Proteins / Q000627:therapeutic use; D050718:Complement C1 Inhibitor Protein; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans
chemical_list: D003174:Complement C1 Inactivator Proteins; D050718:Complement C1 Inhibitor Protein; C469952:SERPING1 protein, human
keywords: C1-inhibitor; acute abdominal pain; angiotensin-converting enzyme inhibitors; hereditary angioedema; intestinal angioedema