Angiotensin-converting enzyme inhibitor angioedema of the intestine: a case report and review of the literature.

Visceral angioedema is a rare complication of angiotensin-converting enzyme (ACE) inhibitor use. To date, 15 cases have been reported in the literature. Common presentation is that of a middle-aged woman with abdominal pain, emesis, and diarrhea who has recently begun taking an ACE inhibitor. Signs include leukocytosis, ascites, and edematous small bowel seen on computed tomography. Diagnosis is elusive, and frequently invasive procedures, including surgery, are pursued. These can be avoided if the astute physician recognizes the association and withdraws the offending medication. We present the typical diagnostic dilemma faced in the evaluation of a patient with ACE inhibitor angioedema of the intestine, and review the current available literature.