lisinopril and Intestinal-Diseases

Topics: Abdominal Pain; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Ascites; Duodenal Diseases; Female; Humans; Intestinal Diseases; Jejunal Diseases; Lisinopril; Middle Aged; Proteinuria; Tomography, X-Ray Computed

We describe a case of a 72-year-old woman who presented with two episodes of abdominal pain, vomiting, and diarrhea. Abdominal computed tomographic scans done during each episode demonstrated edema of the small bowel. Review of the patient's history revealed that she had been started on a treatment of lisinopril for hypertension 1 month before the first episode and had her prescribed dose increased 24 hours before each presentation. Angiotensin-converting enzyme (ACE) inhibitor-associated angioedema was suspected and the medication was discontinued. The patient has remained symptom-free while not taking the ACE inhibitor for 1 year. Review of the literature reveals only nine similar cases. All cases, including ours, occurred in women. Angioedema of the small bowel associated with ACE inhibitors is rare and often is not recognized before surgical exploration. Angioedema of the gastrointestinal tract should be considered in symptomatic patients taking ACE inhibitors.

Topics: Aged; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Female; Humans; Hypertension; Intestinal Diseases; Intestine, Small; Lisinopril

Topics: Adult; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Female; Humans; Intestinal Diseases; Intestine, Small; Lisinopril; Radiography

Acute abdominal pain is the reason for 5% to 10% of all emergency department visits. In 1 in every 9 patients, operated on for an acute abdomen, laparotomy is negative. In a minority of patients, the acute abdomen is caused by side effects of medication. We present a case of unnecessary abdominal surgery in a patient with acute abdominal pain caused by intestinal angioedema (AE), which was eventually due to angiotensin-converting enzyme inhibitor (ACE-i) use. We hope that this case report increases awareness of this underdiagnosed side effect. Emergency department physicians, surgeons, internists, and family physicians should always consider ACE-i in the differential diagnosis of unexplained abdominal pain. Since early withdrawal of the medication causing intestinal AE can prevent further complications and, in some cases, needless surgery, we propose an altered version of the known diagnostic algorithm, in which ACE-i and nonsteroidal anti-inflammatory drugs-induced AE is excluded at an early stage.

Topics: Abdomen, Acute; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Female; Humans; Intestinal Diseases; Lisinopril; Middle Aged; Tomography, X-Ray Computed; Unnecessary Procedures

To report a case of possible lisinopril-induced angioedema of the small bowel.. 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.. 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.. Angiotensin-converting enzyme inhibitor-related small bowel angioedema should be considered in the differential diagnosis of unexplained abdominal pain.

Topics: Abdominal Pain; Aged; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Diagnosis, Differential; Diarrhea; Female; Humans; Intestinal Diseases; Intestine, Small; Lisinopril; Nausea; Time Factors; Tomography, X-Ray Computed; Vomiting

Angiotensin-converting enzyme (ACE) inhibitors are standard medication in treating hypertension, heart failure and diabetic nephropathy. The most common side effects are cough and angioneurotic oedema of the upper airways. A less familiar side effect is the ACE inhibition-induced visceral angioedema. We report the case of a young female patient with recent diagnosis of heart failure (dilated cardiomyopathy due to viral myocarditis), who developed angioedema of the small intestine three weeks after initiating treatment with lisinopril. Symptoms resolved within days once administration of the drug was stopped.

Topics: Adult; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Female; Heart Failure; Humans; Intestinal Diseases; Intestine, Small; Lisinopril; Time Factors

Topics: Angioedema; Female; Humans; Intestinal Diseases; Intestine, Small; Lisinopril; Middle Aged; Tomography, X-Ray Computed

Topics: Angioedema; Angiotensin-Converting Enzyme Inhibitors; Diagnostic Errors; Humans; Intestinal Diseases; Lisinopril

Topics: Angioedema; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Biphenyl Compounds; Humans; Imidazoles; Intestinal Diseases; Lisinopril; Losartan; Tetrazoles

Topics: Acute Disease; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Humans; Intestinal Diseases; Lisinopril; Pancreatitis; Tomography, X-Ray Computed

Topics: Angioedema; Angiotensin-Converting Enzyme Inhibitors; Humans; Intestinal Diseases; Lisinopril; Tomography, X-Ray Computed