Pediatric hereditary angioedema presenting as recurrent episodic abdominal pain and vomiting: Challenges in diagnosis and management

Recurrent episodic abdominal pain and vomiting, with symptom-free intervals between attacks, represent common and often challenging presentations in children, typically leading to extensive workups without a clear etiology, as standard diagnostic algorithms fail to include rare systemic conditions. We present the challenging diagnostic odyssey of a pediatric patient (symptom onset at age 4 years; diagnosis at age 8), culminating in an unexpected diagnosis of hereditary angioedema, a critical etiology often omitted from differentials. This case underscores a key gap in current clinical pathways and serves to expand the diagnostic consideration for specialists managing unexplained recurrent episodic abdominal symptoms.