Superior mesenteric artery syndrome following initiation of cisplatin-containing chemotherapy: a case report

Abstract

IntroductionSuperior mesenteric artery syndrome is a rare cause of upper intestinal obstruction resulting from compression of the duodenum by the superior mesenteric artery and abdominal aorta.Case presentationWe describe a case of superior mesenteric artery syndrome in a 61-year-old Japanese man with non-small cell lung cancer who had been treated with cisplatin-containing chemotherapy and had lost 7 kg in weight. The diagnosis was confirmed by the typical findings of abdominal computed tomography showing distended stomach resulting from compression of the third portion of the duodenum and reduction of an aortomesenteric distance and aortomesenteric angle.ConclusionsThis case highlights the importance of considering the possibility of superior mesenteric artery syndrome in patients treated with chemotherapy, especially those presenting with a low body mass index and showing weight loss during chemotherapy.

Wilkie’s Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma

“…Most of the previous, albeit rare, reported cases of cancer associated WS occurred as complications after operation or radiotherapy [9]. To the best of our knowledge, this is the second reported case of WS caused by DACa [8].…”

“…CT scanning is very useful as, with three-dimensional reconstruction, additionally aortomesenteric angle and aortomesenteric distance can be measured and intra-abdominal and retroperitoneal fat can be assessed. The CT criteria for the diagnosis of WS are aortomesenteric angle of < 22° and aortomesentric distance of < 8mm which were evident in the current case [6,7,9]. Successful treatment of WS requires identification and removal or reversal of the precipitating cause.…”

“…Among the other predisposing conditions like anorexia nervosa, severe injury such as head trauma and postoperative states leading to prolonged bed rest , burns, malabsorption, constitutional factors like thin body built, exaggerated lumbar lordosis, rapid linear growth without compensatory weight gain, abdominal wall laxity and viceroptosis, spinal deformity or trauma, surgical treatment of vertebral fractures or scoliosis entailing use of body casts and anatomic anomalies like abnormally high and fixed ligament of Treitz and low origin of superior mesenteric artery, depletion of mesenteric fat caused by rapid severe weight loss due to catabolic states like cancer is a recognised cause of WS [6,9]. Confirmation of WS requires radiographic procedures such as upper gastrointestinal series, hypotonic duodenography and contrast CT scanning.…”

Superior mesenteric artery syndrome: a unique complication following carboplatin-based chemotherapy

“…Neoplasms and systemic chemotherapy are well known risk factors for weight loss, but a PubMed literature search revealed only one previously reported case of SMAS in a cancer patient being treated with chemotherapy. 15 Moreover, cases involving SMAS in cancer patients were caused by mechanical compression of the duodenum by the tumor rather than weight loss itself. In the case reported by Ushiki et al, the patient was being treated with cisplatin, a drug strongly associated with severe emesis.…”

A case of pneumoperitoneum and retropneumoperitoneum without bowel perforation due to extensive intestinal necrosis as a complication to chemotherapy: CT evaluation

“…Chemotherapy agents may rarely cause ABI due to secondary vasculitis (6). Chemotherapy may also be related to thrombotic occlusion of the superior mesenteric artery (7).…”