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Radiation Medicine

, Volume 26, Issue 10, pp 618–621 | Cite as

Computed tomography of the gastrointestinal manifestation of hereditary angioedema

  • Masaki WakisakaEmail author
  • Mitsutaka Shuto
  • Hisanori Abe
  • Masaaki Tajima
  • Hidefumi Shiroshita
  • Toshio Bandoh
  • Tsuyoshi Arita
  • Michio Kobayashi
  • Tomoko Nakayama
  • Fumito Okada
  • Hiromu Mori
  • Naoki Uemura
Case Report

Abstract

We report a case of gastrointestinal manifestation of hereditary angioedema. Computed tomography (CT) revealed wall thickening of the gastric antrum, duodenum, and jejunum. Dilatation of the third part of the duodenum, thickening of the small bowel mesentery and omentum, and retroperitoneal edema were present. The importance of considering this condition in patients presenting such CT findings correlated with the appropriate history is discussed.

Key words

Hereditary angioedema Gastrointestinal tract C1 inhibitor deficiency Computed tomography 

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References

  1. 1.
    Agostoni A, Cicardi M. Hereditary and acquired C1-inhibitor deficiency: biological and clinical characteristics in 235 patients. Medicine 1992;71:206–215.PubMedCrossRefGoogle Scholar
  2. 2.
    Visentin DE, Yang WH, Karsh J. C1-esterase inhibitor transfusions in patients with hereditary angioedema. Ann Allergy Asthma Immunol 1998;80:457–461.PubMedCrossRefGoogle Scholar
  3. 3.
    Talavera A, Larraona JL, Ramos JL, Lopez T, Maraver A, Arias J, et al. Hereditary angioedema: an infrequent cause of abdominal pain with ascites. Am J Gastroenterol 1995;90:471–474.PubMedGoogle Scholar
  4. 4.
    De Backer AI, De Schepper AM, Vandevenne JE, Schoeters P, Michielsen P, Stevens WJ. CT of angioedema of the small bowel. AJR Am J Roentgenol 2001;176:649–652.PubMedGoogle Scholar
  5. 5.
    Wei SC, Fitzgerald K, Maglinte DDT. CT findings in small bowel angioedema: a cause of acute abdominal pain. Emerg Radiol 2007;13:281–283.PubMedCrossRefGoogle Scholar
  6. 6.
    Sekijima Y, Hashimoto T, Koshihara H, Kawachi Y, Otsuka F, Ikeda SI. Massive mesenteric edema in a patient with type I hereditary angioedema. Mod Rheumatol 2005;15:361–363.PubMedCrossRefGoogle Scholar
  7. 7.
    Sadeghi N, Van Daele D, Hainaux B, Engelholm L, Michel O. Hereditary angio-edema involving the gastrointestinal tract: CT findings. Eur Radiol 2001;11:99–101.PubMedCrossRefGoogle Scholar
  8. 8.
    Fisher AJ, Fleishman MJ, Hancock D. Angioedema of the small bowel: CT appearance. AJR Am J Roentgenol 2000;175:554.PubMedGoogle Scholar
  9. 9.
    Nasnas R, Awky J, Aoun N, Haddad S, Slaba S, Atallah N. Intestinal manifestations of angioneurotic edema: a case report. J Radiol 1997;78:1167–1169.PubMedGoogle Scholar
  10. 10.
    Osler W. Hereditary angioneurotic oedema. Am J Med Sci 1888;95:362–367.Google Scholar
  11. 11.
    Hermans C. Successful management with C1-inhibitor concentrate of hereditary angioedema attacks during two successive pregnancies: a case report. Arch Gynecol Obstet 2007;276:271–276.PubMedCrossRefGoogle Scholar
  12. 12.
    Donaldson VH, Evans RR. A biochemical abnormality in hereditary angioneurotic edema: absence of serum inhibitor of C1-esterase. Am J Med 1963;31:37–44.CrossRefGoogle Scholar
  13. 13.
    Lim YC, Kim JK, Shim DB, Lim CH, Jang HJ, Shin HA, et al. Hereditary angioneurotic edema of the larynx. Acta Otolaryngol 2005;125:1240–1243.PubMedCrossRefGoogle Scholar
  14. 14.
    Frank MM. Complement in the pathophysiology of human disease. N Engl J Med 1987;346:1525–1530.CrossRefGoogle Scholar
  15. 15.
    Alsenz J, Borke K, Loos M. Autoantibody-mediated acquired deficiency of C1 inhibitor. N Engl J Med 1987;316:1360–1366.PubMedGoogle Scholar
  16. 16.
    Ciaccia D, Brazer SR, Baker ME. Acquired C1 esterase inhibitor deficiency causing intestinal angioedema: CT appearance. AJR Am J Roentgenol 1993;161:1215–1216.PubMedGoogle Scholar
  17. 17.
    Kim SH, Cho JY, Lim HK. CT findings of isolated small bowel angioedema due to iodinated radiographic contrast medium reaction. Abdom Imaging 1999;24:117–119.PubMedCrossRefGoogle Scholar
  18. 18.
    Shahzad G, Korsten MA, Blatt C, Motwani P. Angiotensinconverting enzyme (ACE) inhibitor-associated angioedema of the stomach and small intestine. Mt Sinai J Med 2006;73:1123–1125.PubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2008

Authors and Affiliations

  • Masaki Wakisaka
    • 1
    Email author
  • Mitsutaka Shuto
    • 2
  • Hisanori Abe
    • 2
  • Masaaki Tajima
    • 3
  • Hidefumi Shiroshita
    • 3
  • Toshio Bandoh
    • 3
  • Tsuyoshi Arita
    • 3
  • Michio Kobayashi
    • 3
  • Tomoko Nakayama
    • 4
  • Fumito Okada
    • 4
  • Hiromu Mori
    • 4
  • Naoki Uemura
    • 5
  1. 1.Department of RadiologyArita Gastrointestinal HospitalOitaJapan
  2. 2.Department of Internal MedicineArita Gastrointestinal HospitalOitaJapan
  3. 3.Department of SurgeryArita Gastrointestinal HospitalOitaJapan
  4. 4.Department of RadiologyOita University Faculty of MedicineYufuJapan
  5. 5.Department of OtolaryngologyOita University Faculty of MedicineYufuJapan

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