Superior mesenteric artery syndrome : a case report and review of literature
Keywords:
Superior mesenteric artery syndrome, Gastric outlet obstructionAbstract
Superior mesenteric artery syndrome (SMAS) is a rare cause of the 3rd part of duodenal obstruction, caused by narrowing of the aortomesenteric angle. Clinical presentations may be gastric outlet obstruction with bilious vomiting or other nonspecific symptoms. The high index of suspicion for early diagnosis should be considered. Radiological investigations such as upper GI study or CT whole abdomen with contrast provided definite diagnosis. SMAS generally responds well to supportive treatment.
We report a case of 21- year- old female patient presented with persistent vomiting and significant weight loss for 3 weeks. Additional imaging revealed narrowing of aortomesenteric angle causing external compression of the 3rd part of duodenum. The patient’s symptoms were improved after 11 days of supportive treatment.
After discharge, the patient’s symptoms were improved. Two weeks later, she developed progressive bloating and vomiting. She came back to hospital and was readmitted in Surgery department with provisional diagnosis of SMAS. Due to failure of conservative treatment, the surgeon planned for duodenojejunostomy. Unfortunately, she developed septic shock and succumbed shortly afterwards.
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