Recurrent Abdominal Pain and Hypotension: A Rare Presentation of Acquired Angioedema

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 311A
Author(s):  
Jorge Sanchez ◽  
Samih Mawari ◽  
Hassan Taha ◽  
Rahul Nanchal
Keyword(s):  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Rare Presentation ◽  
Acquired Angioedema

scholarly journals Refractory Abdominal Pain in a Patient with Chronic Lymphocytic Leukemia: Be Wary of Acquired Angioedema due to C1 Esterase Inhibitor Deficiency

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Abdullateef Abdulkareem ◽  
Ryan S. D’Souza ◽  
Joshua Mundorff ◽  
Pragya Shrestha ◽  
Oluwaseun Shogbesan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Lymphocytic Leukemia ◽  
Upper Airway ◽  
Recurrent Abdominal Pain ◽  
Final Diagnosis ◽  
Lymphocytic Leukemia ◽  
C1 Inhibitor Deficiency ◽  
Acquired Angioedema ◽  
C1 Esterase Inhibitor ◽  
Esterase Inhibitor

Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions. In this article, we present the case of a 62-year-old male with a history of recently diagnosed chronic lymphocytic leukemia (CLL) who presented to our hospital with recurrent abdominal pain, initially suspected to haveClostridium difficilecolitis and diverticulitis. He received a final diagnosis of acquired angioedema due to C1 esterase inhibitor deficiency due to concomitant symptoms of lip swelling, cutaneous nonpitting edema of his lower extremities, and complement level deficiencies. He received acute treatment with C1 esterase replacement and icatibant and was maintained on C1 esterase infusions. He also underwent chemotherapy for his underlying CLL and did not experience further recurrence of his angioedema.

Acquired Angioedema as Unusual Cause of Recurrent Abdominal Pain

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1390
Author(s):  
Sumant Arora ◽  
Barakat Aburajab Altamimi ◽  
Avraham Levin
Keyword(s):  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Acquired Angioedema

scholarly journals Recurrent Right Upper Quadrant Pain Masquerading an Underlying Colon Adenocarcinoma-Induced Intussusception

2021 ◽  
pp. 501-506
Author(s):  
Zeena Ayad Qiryaqoz ◽  
Urvashi Katiyar ◽  
Saad Shebrain
Keyword(s):  
Abdominal Pain ◽  
Surgical Intervention ◽  
Colon Adenocarcinoma ◽  
Unknown Origin ◽  
Recurrent Abdominal Pain ◽  
Quadrant Pain ◽  
Rare Presentation ◽  
Delay In Diagnosis ◽  
Therapeutic Outcomes ◽  
High Degree

Intussusception in adults is a challenging diagnosis that often requires a high degree of suspicion. In adults presenting with symptoms, almost 90% have underlying neoplasms. Most frequently, the presentation will include nonspecific abdominal pain, vomiting, and mucoid hematochezia. In this case, we present a 39-year-old female with a rare presentation of chronic, recurrent right upper quadrant abdominal pain over a 5-month interval. The misleading presentation with which the patient presented led to a delay in diagnosis and treatment of colon malignancy and serves to advocate for intussusception as a differential for adult patients presenting with obstructive symptoms of unknown origin and recurrent abdominal pain. Such cases should persuade physicians to plan prompt surgical intervention as to not delay optimal diagnostic and therapeutic outcomes.

scholarly journals A112 ANGIOEDEMA,A RARE YET AN IMPORTANT CAUSE OF ABDOMINAL PAIN. A CASE STUDY AND LITERATURE REVIEW

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 130-131
Author(s):  
F M Almalki ◽  
M Cino ◽  
S Betschel ◽  
A N Sasson
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Subcutaneous Tissue ◽  
Recurrent Abdominal Pain ◽  
Distal Segment ◽  
Interesting Case ◽  
Double Balloon Enteroscopy ◽  
Acquired Angioedema ◽  
Common Causes ◽  
History Of

Abstract Background Abdominal pain is a common gastroenterological symptom with an extensive deferential diagnoses. Angioedema is an important cause to remember after the more common causes have been excluded.It is caused by a deficiency in the inhibitor of the first component of classical complement pathway and is divided into hereditary or acquired.Acquired angioedema is associated with autoimmune or lymphoproliferative neoplasms.The clinical features of both include recurrent,self-limiting and circumscribed edema affecting the subcutaneous tissue of the upper respiratory airways and gastrointestinal tract. Aims We describe an interesting case of acquired angioedema presenting with recurrent abdominal pain. We also systematically review the current literature on this rare entity. Methods A search of electronic databases was performed inclusive to September 2019, for all studies and reviews of patients with acquired angioedema manifested as recurrent attacks of abdominal pain. Results: Case Report: 65 year old lady ho has an at least 2 year long history of abdominal pain and bloating associated on some occasions with nausea and vomiting.She presented to our emergency department in August,2018 with a day history of severe generalized abdominal pain and was found to have circumferential thickening,edema with mucosal hyperenhancement involving the distal segment of the small bowel.Splenomegaly was noted on that study.A double balloon enteroscopy was planned,but ultimately cancelled as her ileitis had resolved.The patient was discharged home as her pain resolved with conservative management which included intravenous fluid, pain medications and antiemetics.She then represented to the hospital on September 16, 2019 severe abdominal pain and throat tightness associated with shortness of breath. Again,noted was an extremely short segment of ileum with mucosal edema and hyperenhancement which resolved on a repeat CT scan done during that admission on September 18th, 2019.In light of the patient’s symptoms,CT scan findings,progressive anemia, thrombocytopenia and splenomegaly. It was thought that her abdominal pain is related to secondary to angioedema driven by a lymphoproliferative process as evident by the splenomegaly and worsening cytopenia. A bone marrow was done which revealed clonal B, so the diagnosis of lymphoma was made. The patient’s C1 esterase was 0.2 with reduced functional activity.CH50 less 10 perecent. A diagnosis of acquired angioedema was made and the patient was started on BERINERT 3000 IU SQ every three days with 1500 IU for break through with significant improvement in the frequency and severity of abdominal pain episodes. Conclusions Acquired angioedema is to be considered as a cause of recurrent abdominal pain in a patient with a lymphoproliferative malignancy after common causes and etiologies have been ruled out. Funding Agencies None

A RARE CAUSE OF SEVERE RECURRENT ABDOMINAL PAIN

2013 ◽  
Vol 68 (1) ◽  
pp. 68-70
Author(s):  
C Isen ◽  
C Ivens ◽  
SFJ Callens ◽  
J Meeuwissen ◽  
A Vonck ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Recurrent Abdominal Pain

scholarly journals Recurrent abdominal pain in 52‐year‐old male

2015 ◽  
Vol 3 (6) ◽  
pp. 504-505
Author(s):  
Giovanni D. De Palma ◽  
Francesco Maione ◽  
Dario Esposito ◽  
Saverio Siciliano ◽  
Nicola Gennarelli ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Recurrent Abdominal Pain

scholarly journals Laparoscopic reduction and repair of a left paraduodenal hernia

2019 ◽  
Vol 12 (12) ◽  
pp. e232098 ◽  
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Repair ◽  
Recurrent Abdominal Pain ◽  
Paraduodenal Hernia ◽  
Enhanced Ct ◽  
History Of ◽  
Congenital Internal Hernia ◽  
Continuous Closure ◽  
Hernia Orifice ◽  
Similar Episode

Left paraduodenal hernias are the most common type of congenital internal hernia, but they are difficult to diagnose without appropriate imaging. A 79-year-old man with a history of recurrent abdominal pain had another similar episode of abdominal pain, which prompted him to seek evaluation. The pain resolved spontaneously on arrival to the hospital. Enhanced CT scan showed the characteristic findings of a left paraduodenal hernia and laparoscopic repair was undertaken. The small intestine was reduced successfully, and the hernia orifice was approximated with a continuous closure. He was discharged uneventfully 4 days after admission. The characteristic clinical and imaging findings of paraduodenal hernias are reviewed. Laparoscopic repair is reasonable in patients who have a paraduodenal hernia without intestinal ischemia.

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