Intermittent Abdominal Pain and Intestinal Swelling –a Mystery?

Nice case! What makes this so unusual is angioedema usually involves the face or lips…something very visible that you know isn’t normal.  Intestinal angioedema will cause pain and bloating like your appendix only surgery won’t help that!


A recent “Think Like a Doctor”  -full link to the solved case: 

First an except from the challenge:

The Patient’s History

It started nearly two years earlier, the woman told Dr. Merai. She had been at work — she was a clerk in a bank then — and had suddenly started vomiting. As she made her way back to her desk, she felt weak and unsteady and fainted. Or that’s what everybody told her, because the next thing she knew, she was in an ambulance on the way to the hospital.

There, a CT scan showed that her small intestines were inflamed. The doctors said she might have Crohn’s disease. But after a couple of days, she started to feel better and went home. Because she felt O.K., she never followed up.

And then, it happened again — nine months later. Again she was rushed to the hospital. Again…

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