Intestinal Angioedema Induced by Angiotensin-Converting Enzyme Inhibitors: A Diagnosis of Exclusion

Angiotensin-converting enzyme inhibitor (ACEI)-induced intestinal angioedema is a rare and frequently underdiagnosed condition, often presenting with nonspecific gastrointestinal symptoms that can mimic inflammatory, infectious, or neoplastic diseases. We report the case of a 42-year-old female patient who recently started perindopril (an ACEI) for uncontrolled hypertension and developed recurrent abdominal pain and diarrhea. Extensive laboratory and imaging workup, complemented by endoscopic and histological evaluations, did not identify any alternative etiology. Symptoms resolved completely after discontinuation of perindopril, confirming ACEI-induced intestinal angioedema. Early recognition of this entity is essential to avoid invasive procedures and ensure complete resolution with simple drug discontinuation.