Angiotensin converting enzyme inhibitor ACEI-induced angioedema of the intestine is a rare occurrence and often unrecognized complication of ACEI. We present a case of a 45-year-old Hispanic female with angioedema of the small bowel progressing to facial and oral pharyngeal angioedema. Patients are typically middle-aged females on ACEI therapy who present to the emergency department with abdominal pain, nausea, vomiting, and diarrhea. This is a diagnosis of exclusion, and physicians must have a high index of suspicion to make the diagnosis. Symptoms typically resolve within 24–48 hours after ACE inhibitor withdrawal. Recognizing these signs and symptoms, and discontinuing the medication, can save a patient from unnecessary, costly, and invasive procedures.

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Ischemic colitis (IC) secondary to air embolism from decompression sickness or barotrauma during diving is an extremely rare condition. After extensive review of the available literature, we found that there has been only one reported case of IC secondary to air embolism from diving. Although air embolization from diving and the various medical complications that follow have been well documented, the clinical manifestation of IC from an air embolism during diving is very rare and thus far unstudied. Common symptoms of IC include abdominal pain, bloody or non-bloody diarrhea or nausea or vomiting or any combination. Emergency physicians and Critical Care specialists should consider IC as a potential diagnosis for a patient with the above-mentioned symptoms and a history of recent diving. We report a case of IC from air embolism after a routine dive to 75 feet below sea level in a 53-year-old White female who presented to a community Emergency Department complaining of a 2-day history of diffuse abdominal pain and nausea. She was diagnosed by colonoscopy with biopsies and treated conservatively with antibiotics, bowel rest, and a slow advancement in diet.

Aeromonas hydrophila is an aquatic bacterium that causes sporadic, opportunistic warm-weather soft tissue infections and bacteremias, classically among men with predisposing liver disorders or leukemias. Although the portal of entry often remains elusive, the end result in these immunodeficient populations can be devastating.At our institution, we exhaustively reviewed patient charts and records and identified A. hydrophila from fluid specimens in 24 symptomatic patients with cancer over a period of 23 years. Seven of our patients were male and the other 17 patients were female, and the median age was 64 years.Predisposing conditions were identified as follows: Six of them had solid organ malignancies, and two had a diagnosis of hematologic malignancies; four patients had altered hepatic function, whereas 3 patients had neutropenia. Only one patient was found to have the classical risk factor of liver cirrhosis, in this case, secondary to chemotherapy.The 2 patients exhibiting soft tissue manifestations of Aeromonas acquired the bacterium in the community and presented with local abscess and fever. Only one of the 2 patients gave a history of fresh water exposure. We successfully managed these 2 patients with nonsurgical intervention.