Combined superior mesenteric artery syndrome and nutcraker syndrome presenting as acute pancreatitis: a case report

Abstract

Superior mesenteric artery syndrome designates compression of the third part of the duodenum between the superior mesenteric artery and the aorta. This condition has a low incidence, being more common in thin young women. Nutcracker syndrome is compression of the left renal vein between the superior mesenteric artery and the aorta. Both entities are rare, and their coexistence has been reported in a few cases. Conservative treatment targeting weight gain is sufficient in most cases. An association between the superior mesenteric artery syndrome and acute pancreatitis has rarely been reported. We intend to describe the case of an 18-year-old girl who was admitted to the emergency room with epigastric pain and emesis. Our investigation revealed acute acalculous pancreatitis. During work-up, we discovered superior mesenteric artery syndrome and a compressed left renal vein. The patient is on conservative treatment, and her symptoms have improved.

Pancreatic pseudocyst, gastric outlet obstruction, superior mesenteric artery syndrome and renal vein entrapment syndrome in groove pancreatitis: a case report

“…This patient with GP and SMA syndrome, pathologies not previously reported together in literature, showcases a poorly understood condition while stressing GP as a challenging diagnosis for patients with nonspecific symptoms while highlighting the challenges in pain management. Additionally, the simultaneous occurrence of SMA syndrome and nutcracker syndrome is rare as their coexistence has only been reported in a few cases, but these syndromes should be evaluated for by radiologists as potentially shared pathophysiology impacts patient management [ 14 , 15 ].…”