A 25-year-old female with recurrent abdominal pain

A 25-year-old female patient, who had a history of medical treatment with the diagnosis of asthma for the last two years, presented with complaints of abdominal pain, nausea, and vomiting. Similar complaints recurred several times over the previous two months and regressed spontaneously in his medical history. These symptoms were acute onset and lasted for 6-8 hours. She had no history of weight loss or fever. Family history revealed the patient’s mother had a history of recurrent swelling of the face and lips, which resolved spontaneously, and her father had coronary artery disease. Physical examination revealed epigastric tenderness without guarding. Labora- tory test results were within normal limits, except for low hemoglobin level (13.2 g/dL; reference range 14-16 g/ dL). Abdominal ultrasound showed mild peri-intestinal free fluid, and contrast-enhanced abdominal computed tomography (CT) was obtained for further evaluation. Abdominal CT showed an edematous thickening of the duodenum wall and peri-intestinal free fluid (Figure 1). The remaining abdominal CT findings were within normal limits.