scholarly journals ACE Inhibitor-Induced Angioedema of the Bowel

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Tabitha Campbell ◽  
Bradley Peckler ◽  
Raleigh David Hackstadt ◽  
Austin Payor
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Ace Inhibitor ◽  
Enzyme Inhibitor ◽  
Signs And Symptoms ◽  
Converting Enzyme ◽  
Rare Occurrence ◽  
Invasive Procedures ◽  
High Index Of Suspicion

Angiotensin converting enzyme inhibitor ACEI-induced angioedema of the intestine is a rare occurrence and often unrecognized complication of ACEI. We present a case of a 45-year-old Hispanic female with angioedema of the small bowel progressing to facial and oral pharyngeal angioedema. Patients are typically middle-aged females on ACEI therapy who present to the emergency department with abdominal pain, nausea, vomiting, and diarrhea. This is a diagnosis of exclusion, and physicians must have a high index of suspicion to make the diagnosis. Symptoms typically resolve within 24–48 hours after ACE inhibitor withdrawal. Recognizing these signs and symptoms, and discontinuing the medication, can save a patient from unnecessary, costly, and invasive procedures.

Consideration of pulmonary thromboembolism in paediatric patients presenting to the emergency department with abdominal pain

2021 ◽  
Vol 14 (5) ◽  
pp. e239175
Author(s):  
Wasyla Ibrahim ◽  
Farhat Mushtaq
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Lower Limb ◽  
Pulmonary Thromboembolism ◽  
Signs And Symptoms ◽  
Paediatric Population ◽  
Limb Trauma ◽  
High Index Of Suspicion ◽  
Lower Limb Trauma

Venous thromboembolism (VTE) is a recognised complication of lower limb trauma in adult patients and classically presents with cardiopulmonary symptoms. However, the risk of VTE and its presenting signs and symptoms are less well documented in the paediatric population. We report the case of a child who presented to our emergency department with abdominal pain 2 weeks after lower limb fracture, who was subsequently found to have a pulmonary thromboembolism (PTE). This case report highlights the importance of having a high index of suspicion for VTE in the paediatric population if there are predisposing risk factors and to consider PTE as a differential cause of abdominal pain. To the authors’ knowledge, no case has been described in which a child presenting with abdominal pain was consequently found to have a pulmonary embolism.

Possible Angiotensin-Converting Enzyme Inhibitor (ACEI)-Induced Small Bowel Angioedema

2011 ◽  
Vol 24 (6) ◽  
pp. 564-567 ◽  
Author(s):  
Emily C. Haines ◽  
Geoffrey C. Wall
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Wall Thickening ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitor ◽  
Abdominal Symptoms ◽  
Inflammatory Changes

Objective: To report a case of possible lisinopril-induced angioedema of the small bowel. Case Summary: 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. Discussion: 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.

B-Lymphoblastic Lymphoma of the Small Bowel: An Extremely Rare Occurrence

2021 ◽  
pp. 000313482199867
Author(s):  
Nikolaos G Symeonidis ◽  
Kalliopi E Stavrati ◽  
Efstathios T Pavlidis ◽  
Kyriakos K Psarras ◽  
Eirini Martzivanou ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Soft Tissues ◽  
Lymphoblastic Lymphoma ◽  
Emergency Laparotomy ◽  
Rare Occurrence ◽  
Small Bowel Tumor ◽  
Gastrointestinal Lesions ◽  
Immature B Cells ◽  
B Lymphoblastic Lymphoma

B-lymphoblastic lymphoma is a neoplasm of immature B cells and is characterized by aggressive behavior and disease progression. Common sites of involvement are skin, lymph nodes, bone, soft tissues, breast, and the mediastinum. Gastrointestinal lesions are rarely encountered and therefore not fully described. We herein report the case of a 28-year-old male, who presented with abdominal pain and CT scan showed a tumor involving the small bowel and its mesentery. He underwent emergency laparotomy and enterectomy. Histopathology report revealed B-lymphoblastic lymphoma affecting the small bowel and the adjacent mesentery. This is the first documented case of a small bowel tumor diagnosed as B-lymphoblastic lymphoma in published literature.

scholarly journals A systematic review and meta-analysis of angiotensin-converting enzyme inhibitor use and psoriasis incidence

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gonjin Song ◽  
Ji Yea Kim ◽  
Ha Young Yoon ◽  
Jeong Yee ◽  
Hye Sun Gwak
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Subgroup Analysis ◽  
Ace Inhibitor ◽  
Web Of Science ◽  
Enzyme Inhibitor ◽  
Meta Analysis ◽  
Temperate Climate ◽  
Converting Enzyme

AbstractAlthough a considerable volume of data supporting induction or aggravation of psoriasis because of angiotensin-converting enzyme (ACE) inhibitor use exists, it remains insufficient for definitive conclusions. Therefore, we aimed to evaluate the association between ACE inhibitor use and psoriasis incidence through a systematic literature review and meta-analysis. We searched for qualifying studies across PubMed, Web of Science, and Embase. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between ACE inhibitor use and psoriasis incidence. Eight studies with a total of 54,509 patients with a psoriasis diagnosis were included in this meta-analysis. The pooled OR for psoriasis incidence among ACE inhibitor users was 1.52 (95% CI, 1.16–2.00) compared to that among non-users. From subgroup analysis by continent, the OR for ACE inhibitor users versus non-users was 2.37 (95% CI 1.28–4.37) in Asia. Per the subgroup analysis by climate, the OR for ACE inhibitor users vs non-users in dry climate was 3.45 (95% CI: 2.05–5.79) vs 1.32 (95% CI 1.01–1.73) in temperate climate. Our results reveal a significant association between ACE inhibitor use and psoriasis incidence.

Four common diseases causing sudden blindness or death in the eye emergency department

2020 ◽  
pp. postgradmedj-2020-138163
Author(s):  
Ana Leonor Rei da Cruz Escaleira ◽  
Dimitrios Kalogeropoulos ◽  
Chris Kalogeropoulos ◽  
Soon Wai Ch’Ng ◽  
Velota C T Sung ◽  
...  
Keyword(s):  
Emergency Department ◽  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Ocular Motility ◽  
Ocular Manifestations ◽  
Ischaemic Attack ◽  
High Index Of Suspicion ◽  
Sudden Blindness ◽  
Patient At Risk ◽  
Prompt Diagnosis

Neuro-ophthalmological emergency disorders typically present with symptoms of visual loss, diplopia, ocular motility impairment or anisocoria. The ocular manifestations of these disorders are sometimes indicative of a more serious global neurology disease rather than an isolated ocular disease. The aim of this review is to highlight four important neuro-ophthalmological emergency disorders that must not be missed by an ophthalmologist. These include acute painful Horner’s syndrome, painful cranial nerve III palsy, giant cell arteritis and transient ischaemic attack with amaurosis fugax. The delayed diagnosis of these clinical entities puts the patient at risk of blindness or death. Therefore, prompt diagnosis and management of these conditions are essential. This can be acquired from understanding the main signs and symptoms of the disease presentation together with a high index of suspicion while working at a busy eye emergency department.

scholarly journals Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244532
Author(s):  
Rodrigo A. Brandão Neto ◽  
Julio F. Marchini ◽  
Lucas O. Marino ◽  
Julio C. G. Alencar ◽  
Felippe Lazar Neto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Multivariate Analysis ◽  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Angiotensin Ii Receptor Blocker ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
All Cause Mortality

Background The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients. Methods From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others. Results From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality Conclusions This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies. Trial registration The study was registered in the Brazilian registry of clinical trials: RBR-5d4dj5.

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