Anorexia Nervosa versus Superior Mesenteric Artery Syndrome in a Young Woman: Case Report and Literature Review

AlHadi, Ahmad N.; SSC-Psych, Raafat Mahmoud Shuqdar

doi:10.1016/s1658-3612(08)70044-1

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…They are characterized by a loss of control over eating, weight loss by dieting, vomiting, laxative use and excessive exercise. It is suggested that eating disorders may occur due to genetic and physiological influences [ 3 , 4 ]. When a teenager present with these symptoms, it is not uncommon for a parent to take their child to a physician.…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients will have an undiagnosed pathology that could be missed, including Addison disease and Wilkie’s syndrome [ 6 ], as was presented in our case. Since Rokitansky first description in 1861, Wilkie’s syndrome is a rare cause of duodenal obstruction [ 4 ] caused by the compression of the third portion of the duodenum by the SMA or one of its branches against the aorta [ 5 , 7 ]. Anatomically, the SMA leaves the aorta at an acute angle that is sustained by adipose tissue, this tissue functions as a natural fatty cushion and prevents extrinsic compression [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…When a conservative treatment fails, surgery is usually indicated. Gastrojejunostomy, duodenojejunostomy, or division of the ligament of Treitz could be performed [ 4 ]. The use of open and laparoscopic approaches have been previously reported [ 7 , 8 ], with the latter presenting benefits including shorter hospitalization time and less pain [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Wilkie’s syndrome, a missed opportunity

Molina

Andrade

Rodríguez³

et al. 2018

Journal of Surgical Case Reports

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Wilkie’s syndrome is a rare cause of duodenal obstruction that can easily be missed at clinical practice. It is characterized by nausea, abdominal pain and vomit. It usually affects young adults, and it’s caused by a low aortomesenteric angle resulting in vascular compression of the duodenum. Symptoms could resemble many of the symptoms presented in a patient with a suspected eating disorder. The non-specificity of the clinical signs and symptoms can confuse, delay the diagnosis and expose the patient to potentially hazardous therapies. We report a case of a 20-year-old patient who presented to the emergency room with a history of intermittent vomiting and abdominal pain. He had been previously misdiagnosed with an eating disorder and received physiological therapy. Nonetheless, his pain persisted. After further evaluation with the use of imaging techniques, a low aortomesenteric angle was discovered. He underwent surgery and completely recovered. On follow up controls patient is well and he no longer had episodes of vomiting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Wilkie’s syndrome, a missed opportunity

Molina

Andrade

Rodríguez³

et al. 2018

Journal of Surgical Case Reports

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Complicaciones Médicas De Los Trastornos De La Conducta Alimentaria

Gabler

Olguin

Rodríguez

2017

Revista Médica Clínica Las Condes

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Síndrome de la arteria mesentérica superior en una paciente con leucemia linfoblástica aguda. Reporte de caso

Bustos-Guerrero,

Alfonso-Valderrama

2024

Case reports

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Resumen Introducción. El síndrome de la arteria mesentérica superior, también llamado síndrome de Wilkie, ocurre por la disminución del ángulo aortomesentérico con compresión de la tercera porción duodenal. La sintomatología en muchos casos es inespecífica y su etiología se presenta por causas relacionadas con disminución de la grasa mesentérica. El diagnóstico se basa en hallazgos imagenológicos y endoscópicos. Su tratamiento se enfoca en corregir la causa relacionada con la pérdida de peso y, en casos refractarios, está indicado el manejo quirúrgico. Presentación del caso. Mujer de 19 años que asistió a una institución de tercer nivel de complejidad en la ciudad de Bucaramanga (Colombia), por sintomatología de 2 meses consistente en pérdida de peso y pérdida parcial del apetito. Las pruebas de sangre mostraron anemia e hiperleucocitosis con 37% de blastos, por lo que se hizo dictamen de leucemia linfoide aguda diagnosticada por aspiración de médula ósea. Durante su estancia hospitalaria presentó dolor abdominal, vómito e intolerancia a la vía oral. En la tomografía de abdomen se observó distensión de la tercera y cuarta porción duodenal y una reducción del ángulo aortomesentérico (18.8º), lo que generó una obstrucción mecánica proximal del intestino. Se inició manejo médico, nutrición parenteral total y terapia postural postprandial. En imágenes de vías digestivas de control se evidenció un adecuado paso de medio de contraste hasta el yeyuno. La paciente toleró el inicio de la vía oral y presentó una buena evolución clínica. Conclusiones. El síndrome de la arteria mesentérica superior es una causa poco frecuente de obstrucción intestinal con características clínicas variables, por lo que se requiere una alta sospecha diagnóstica. Se deben realizar estudios imagenológicos para confirmar el diagnóstico e iniciar manejo médico de forma temprana para evitar posibles intervenciones quirúrgicas.

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Anorexia Nervosa versus Superior Mesenteric Artery Syndrome in a Young Woman: Case Report and Literature Review

Cited by 4 publications

References 27 publications

Wilkie’s syndrome, a missed opportunity

Wilkie’s syndrome, a missed opportunity

Complicaciones Médicas De Los Trastornos De La Conducta Alimentaria

Síndrome de la arteria mesentérica superior en una paciente con leucemia linfoblástica aguda. Reporte de caso

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