Transient Angioedema of the Small Bowel Associated with Iodinated Contrast in Children

This article presents three cases of transient angioedema of the small bowel wall caused by the intravenous administration of a non-ionic iodinated contrast agent during computed tomography (CT) scans in children. The imaging patterns characteristic of this condition, the symptoms and outcomes are described, approaches to differential diagnosis are discussed.

1. Batischeva G.A., Zhdanova O.A., Perova N.N., Kotelnikova T.E., Goncharova N.Y., Ryaskin K.A. Adverse Reactions of High-Osmolar and Low-Osmolar Radiographic Contrast Media in Clinical Practice. Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice. 2022;(4):60-72. (In Russ.) https://doi.org/10.37489/2588-0519-2022-4-60-72

2. On approval of the Pharmacovigilance Procedure: Order of Roszdravnadzor of February 15, 2017 № 1071, registered by the Ministry of Justice of Russia on March 20, 2017 № 46039, entered into force on 1 april 2017

3. Beiner L, Boehm I. Risk Factor Analysis of Iodinated Contrast Medium-Related Hypersensitivity Reactions. Insights Imaging. 2025 Oct 10;16(1):216. doi: 10.1186/s13244-025-02099-y

4. Blake SP, McNicholas MM. Hypersensitivity to Intravenous Contrast Material Causing CT Appearance of Bowel Wall Thickening. Clin Radiol. 2004 Jul;59(7):638-40. doi: 10.1016/j.crad.2004.01.013

5. Hu XH, Gong XY, Hu P. Transient Small Bowel Angioedema due to Intravenous Iodinated Contrast Media. World J Gastroenterol. 2012 Mar 7;18(9):999-1002. doi: 10.3748/wjg.v18.i9.999

6. Kulkarni KN, Hegde RG, Balani A, Joshi AR. Transient Angioedema of Small Bowel Secondary to Intravenous Iodinated Contrast Medium. Indian J Radiol Imaging. 2014 Jul;24(3):303-5. doi: 10.4103/0971-3026.137065

7. Maarek R, Sellier N, Seror O, Sutter O. Small Bowel Angioedema due to Intravenous Administration of Gadobenate Dimeglumine. Diagn Interv Imaging. 2019 Jul-Aug;100(7-8):459-460. doi: 10.1016/j.diii.2019.03.006

8. Manganaro PMJ, López Grove R, Spina JC. Bowel Angioedema Induced by Iodinated Contrast Media. Rev Esp Enferm Dig. 2022 Jun;114(6):365-366. doi: 10.17235/reed.2022.8627/2022

9. Mortelé KJ, Oliva MR, Ondategui S, Ros PR, Silverman SG. Universal Use of Nonionic Iodinated Contrast Medium for CT: Evaluation of Safety in a Large Urban Teaching Hospital. AJR Am J Roentgenol. 2005 Jan;184(1):31-4. doi: 10.2214/ajr.184.1.01840031

10. Rašiová M, Schlager O, Heiss C, Brodmann M, Olinic DM, Boc V, Buso G, Belch J, Mazzolai L, Madaric J. Adverse Reactions After Intravascular Iodinated Contrast Media Administration and Their Management. Vasa. 2024 May;53(3):193-203. doi: 10.1024/0301-1526/a001122

11. Seo N, Chung YE, Lim JS, Song MK, Kim MJ, Kim KW. Bowel Angioedema Associated with Iodinated Contrast Media: Incidence and Predisposing Factors. Invest Radiol. 2017 Sep;52(9):514-521. doi: 10.1097/RLI.0000000000000371

12. Seong Y, Kim PH, Suh CH, Park KJ, Park HJ, Lee CW, Jung AY, Cho YA, Lee JS, Yoon HM. Acute Adverse Reactions to Nonionic Low-Osmolar Iodinated Contrast Media in Children: A Retrospective Study of 23,429 Injections Over 6 Years. Korean J Radiol. 2025 Oct;26(10):986-997. doi: 10.3348/kjr.2025.0263

13. Van der Molen AJ, Laguna JJ, van de Ven AAJM, Vega F. Very Rare Adverse Reactions to Intravascular Contrast Media: From Kounis to Sweet Syndrome. Eur J Radiol. 2025 Jun;187:112066. doi: 10.1016/j.ejrad.2025.112066

14. Wakabayashi T, Sasaoka Y, Sakai Y, Miyamoto S, Tsugawa T, Kawasaki Y. Transient Angioedema of the Small Bowel because of Intravenous Nonionic Iodinated Contrast Media. J Pediatr. 2021 Mar;230:264-265. doi: 10.1016/j.jpeds.2020.11.04