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CT of Angioedema of the Small Bowel

A. I. De Backer1, A. M. De Schepper1, J. E. Vandevenne2, P. Schoeters3, P. Michielsen3 and W. J. Stevens4

1 Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium.
2 Department of Radiology, St.-Jan Ziekenhuis Z.O.L., Schiepse Bos 6, B-3600 Genk, Belgium.
3 Department of Gastroenterology, University Hospital Antwerp, B-2650 Edegem, Belgium.
4 Department of Immunology, Allergology and Rheumatology, University Hospital Antwerp, B-2650 Edegem, Belgium.



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  		Fig. 1A. —50-year-old woman with idiopathic angioedema of small bowel. CT scans show marked bowel wall enhancement with regular thickened mucosal folds (solid straight arrows, B), clear delineation of different layers of small-bowel wall (open straight arrows, A), and prominent mesenteric vessels (long thin arrows, A). Fluid accumulation within dilated small-bowel loops (open curved arrows) and ascites (solid curved arrows) are also present.

 


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  		Fig. 1B. —50-year-old woman with idiopathic angioedema of small bowel. CT scans show marked bowel wall enhancement with regular thickened mucosal folds (solid straight arrows, B), clear delineation of different layers of small-bowel wall (open straight arrows, A), and prominent mesenteric vessels (long thin arrows, A). Fluid accumulation within dilated small-bowel loops (open curved arrows) and ascites (solid curved arrows) are also present.

 


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  		Fig. 2. —36-year-old woman with hereditary angioedema. CT scan shows prominent fold thickening (curved arrow) of ileum (stacked-coin appearance). Pelvic ascites (straight arrows) is also present.

 


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  		Fig. 3A. —42-year-old man treated for 3 days with angiotensin-converting enzyme inhibitor for hypertension and hospitalized with severe hypovolemic shock. CT scan shows thickening of small-bowel wall and folds (solid straight arrow). Marked enhancement of small-bowel mucosa and clear delineation of the different layers of small-bowel wall (open curved arrow) are evident. Fluid accumulation can be seen in small bowel (open straight arrow) and colon loops (solid curved arrows).

 


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  		Fig. 3B. —42-year-old man treated for 3 days with angiotensin-converting enzyme inhibitor for hypertension and hospitalized with severe hypovolemic shock. CT scan obtained 4 days after A shows bowel wall thickening has completely resolved (arrow).

 

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