{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:05:10Z","timestamp":1777593910123,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,7]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>ACE inhibitors (ACEi) are common anti-hypertensive drugs that can cause angioedema. Though classic, or facial angioedema is rare, visceral angioedema is even less common. When angioedema occurs, it typically presents early, within 30 days of initiating therapy. Visceral angioedema most commonly presents with nausea, emesis, abdominal pain and diarrhoea, and thus is often mistaken for an episode of gastroenteritis. When a CT scan is obtained, it typically shows characteristic findings, including ascetic fluid, mild mesenteric oedema and thickening of the small bowel. In this case report, we present a patient who did not experience her first episode of visceral angioedema until after she had been on ACEi therapy for 5\u20137\u2009years. In addition, she experienced recurrent episodes of visceral angioedema that were separated by approximately 4\u2009years at a time. Both of these features make for a particularly unique presentation.<\/jats:p>","DOI":"10.1136\/bcr-2019-230865","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T07:25:23Z","timestamp":1568877923000},"page":"e230865","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["An unusual presentation of ACE inhibitor-induced visceral angioedema"],"prefix":"10.1136","volume":"12","author":[{"given":"Amanda Jayne","family":"Krause","sequence":"first","affiliation":[{"name":"Internal Medicine, McGaw Medical Center of Northwestern University, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naiya Balubhai","family":"Patel","sequence":"additional","affiliation":[{"name":"Internal Medicine, McGaw Medical Center of Northwestern University, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Morgan","sequence":"additional","affiliation":[{"name":"Internal Medicine, McGaw Medical Center of Northwestern University, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"2025082712110261000_12.9.e230865.1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.jaip.2017.02.018","article-title":"Epidemiology of ACE inhibitor angioedema utilizing a large electronic health record","volume":"5","author":"Banerji","year":"2017","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2025082712110261000_12.9.e230865.2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32834b4b9b"},{"key":"2025082712110261000_12.9.e230865.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2006.06.010"},{"key":"2025082712110261000_12.9.e230865.4","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamainternmed.34"},{"key":"2025082712110261000_12.9.e230865.5","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1002\/ccr3.925","article-title":"Isolated intestinal type angioedema due to ACE-inhibitor therapy","volume":"5","author":"Palmquist","year":"2017","journal-title":"Clin Case Rep"},{"key":"2025082712110261000_12.9.e230865.6","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4451"},{"key":"2025082712110261000_12.9.e230865.7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1177\/0897190017690641","article-title":"ACE inhibitor-induced angioedema of the small bowel: a case report and review of the literature","volume":"31","author":"Wilin","year":"2018","journal-title":"J Pharm Pract"},{"key":"2025082712110261000_12.9.e230865.8","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1D458"},{"key":"2025082712110261000_12.9.e230865.9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.clinre.2016.09.007","article-title":"Angioedema of the small intestine: a great imitator","volume":"41","author":"Alagheband","year":"2017","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"2025082712110261000_12.9.e230865.10","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4856"},{"key":"2025082712110261000_12.9.e230865.11","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1155\/2001\/247816","article-title":"ACE inhibitor-induced angioedema of the intestine: case report, incidence, pathophysiology, diagnosis and management","volume":"15","author":"Oudit","year":"2001","journal-title":"Can J Gastroenterol"},{"key":"2025082712110261000_12.9.e230865.12","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1365-2222.2009.03323.x","article-title":"Angiotensin converting enzyme inhibitor induced angio-oedema: a review of the pathophysiology and risk factors","volume":"40","author":"Hoover","year":"2010","journal-title":"Clin Exp Allergy"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230865","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:11:09Z","timestamp":1756321869000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":12,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,18]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bcr-2019-230865"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230865","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}