Chase M P, Fiarman G S, Scholz F J, MacDermott R P
Department of Medicine, Lahey Clinic Medical Center, Burlington, MA, USA.
J Clin Gastroenterol. 2000 Oct;31(3):254-7. doi: 10.1097/00004836-200010000-00017.
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.
我们描述了一例72岁女性患者，她出现了两次腹痛、呕吐和腹泻发作。每次发作期间进行的腹部计算机断层扫描显示小肠水肿。回顾患者病史发现，她在首次发作前1个月开始服用赖诺普利治疗高血压，并且在每次就诊前24小时增加了 prescribed剂量。怀疑是血管紧张素转换酶（ACE）抑制剂相关性血管性水肿，遂停用该药物。该患者在停用ACE抑制剂1年期间一直无症状。文献回顾仅发现9例类似病例。所有病例，包括我们的病例，均发生在女性身上。与ACE抑制剂相关的小肠血管性水肿罕见，且在手术探查前常未被识别。对于服用ACE抑制剂的有症状患者，应考虑胃肠道血管性水肿。
