Diagnosis and management of angioedema with abdominal involvement: a gastroenterology perspective

Abstract

Abdominal involvement in angioedema is often a challenge to diagnose. Acute onset abdominal pain is its most common presenting symptom, and misdiagnosis may lead to unnecessary surgical intervention. Familiarity with the types and presentations of angioedema can be invaluable to clinicians as they consider the differential diagnoses of a patient presenting with abdominal pain. Detailed personal and family histories, careful physical examination of the patient, combined with knowledge of angioedema types, can help clinicians perform their diagnostic evaluation. An accurate diagnosis is essential in order to provide appropriate treatment to patients with angioedema. Depending upon the diagnosis, treatment may be the avoidance of provoking factors (such as allergens or medications), inhibiting histamine-provoked reactions, or treating C1 esterase inhibitor deficiency.

Figure 1

Allergic angioedema pathway.

Figure 2

Pathways Involved in hereditary angioedema and acquired angioedema. C1 INH: C1 esterase inhibitor.

Figure 3

Non-steroidal anti-inflammatory drug-induced angioedema pathway. NSAIDs: Non-steroidal anti-inflammatory drugs; COX-1: Cyclooxygenase-1.