Acute or Recurrent Abdominal Pain: The Eyes Can Only See What the Mind Knows!

oth angiotensin-converting enzyme inhibitors (ACEIs) and ngiotensin receptor blockers (ARBs) are largely used worldide as effective treatment of blood hypertension and ther cardiovascular diseases, including congestive heart ailure and diabetic nephropathy. For instance, in 2011 there ere 164 million prescriptions of ACEIs and 86 million precriptions of ARBs in US.1 Generally, these drugs are well olerated and safe. However, angioedema has been reported o occur in 0.1--0.7% of ACEIs/ARBs users.2--4 This drugnduced condition mainly involves the head and neck -i.e. he facial angioedema -with swelling of the face, tongue, nd lips which occurs in about one of 2500 ACEIs users. An solate gastrointestinal tract involvement -i.e. the visceral ngioedema -occurs less frequently. Differently from the acial angioedema that suddenly manifests within few hours r days from the start of therapy, so that the diagnosis is asily suspected at clinical history, the visceral angioedema iagnosis may remain neglected for years. Indeed, visceral ngioedema no rarely presents with no specific acute or ecurrent abdominal symptoms, mimicking several other bdominal diseases. Therefore, these patients may undergo epeated investigations and, occasionally, worthless surgical nterventions, with consequent waste of health resources nd morbidity for the patient. Since ‘the eyes can only see what the mind knows’, wareness of the ACEIs/ARBs-induced visceral angioedema