Superior mesenteric artery syndrome in a 30-year-old male patient: A case report and literature review

Asbah, Malvina; Shrateh, Oadi N.; Musleh, Asil; Abbadi, Khaled; Nofal, Mohammed; Tarifi, Sulaiman

doi:10.1016/j.ijscr.2023.108267

Cited by 2 publications

(5 citation statements)

References 18 publications

(32 reference statements)

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“…Various imaging studies have been used to differentiate SMA syndrome. Upper-gastrointestinal radiography, which has been the mainstay of diagnosis of SMA syndrome, is said to be diagnostic for findings of contrast loss in the third part of the duodenum just to the right of the midline, delayed emptying of the stomach and duodenum, dilatation of the first and second parts of the duodenum, and reciprocal patterns of peristaltic waves in the proximal third of the duodenum [ 7 ]. Magnetic resonance enterography (MRE) has been performed at the institution of Giuseppe Cicero et al for SMA syndrome due to Crohn’s disease and is useful for detecting anatomic abnormalities of the small intestine in Crohn’s disease and its dysfunction [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Massive Gastric Dilatation and Multi-Organ Ischemia Due to Superior Mesenteric Artery Syndrome: A Rare Case Report

2023

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Patient: Male, 83-year-old Final Diagnosis: Superior mesenteric artery syndrome Symptoms: Shock Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Superior mesenteric artery (SMA) syndrome, a rare condition in which the SMA and aorta occlude the third duodenal portion, can cause serious complications. We present the case of an 83-year-old Japanese man who presented with shock because of massive gastric dilatation due to SMA syndrome and developed multi-organ ischemia. Case Report: The day before admission, the patient had visited the emergency department with abdominal pain and was sent home following spontaneous symptom resolution, but experienced abdominal pain flare-up. His history included diabetes mellitus, hypertension, gastric ulcer, prostatic hypertrophy, esophageal hiatal hernia, and esophageal cancer. Plain computed tomography showed gastric dilatation and obstruction of the duodenal third portion by the SMA, leading to SMA syndrome diagnosis. Since a nasogastric tube could not be manually inserted into the stomach and the gastric dilatation could not be decompressed, the tube was inserted endoscopically. Endoscopy revealed mechanical obstruction of the gastric cardia and gastric mucosal ischemia. He was admitted to intensive care, and blood pressure was maintained with vasopressors and blood transfusion. The next day, contrast-enhanced computed tomography performed for persistently elevated lactate levels revealed extensive ischemia affecting multiple gastrointestinal organs. Surgery and other treatments were considered too risky due to the patient’s advanced age and condition. Best supportive care was administered after discussion with the family, and he died on the second day of hospitalization. Conclusions: SMA syndrome with extensive ischemia and infarction is rare. Given this, clinicians should remain vigilant for its potential complications.

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Section: Discussionmentioning

confidence: 99%

Massive Gastric Dilatation and Multi-Organ Ischemia Due to Superior Mesenteric Artery Syndrome: A Rare Case Report

2023

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“…Superior mesenteric artery (SMA) syndrome is a rare condition that causes duodenal obstruction due to compression by the SMA and the aorta. 1 The etiology of SMA syndrome is multifactorial and can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. 1 , 2 The clinical presentation of SMA syndrome is nonspecific and often mimics other causes of upper gastrointestinal obstruction.…”

Section: Introductionmentioning

confidence: 99%

“… 1 The etiology of SMA syndrome is multifactorial and can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. 1 , 2 The clinical presentation of SMA syndrome is nonspecific and often mimics other causes of upper gastrointestinal obstruction. 3 The diagnosis of SMA syndrome requires a high index of suspicion and correlation of clinical symptoms with radiographic findings.…”

Section: Introductionmentioning

confidence: 99%

“…SMA syndrome is a rare condition that can be challenging to diagnose, as it often mimics other causes of upper gastrointestinal obstruction. 1 The incidence of SMA syndrome is estimated to be between 0.1% and 0.3%. 1 , 2 This case report highlights the importance of considering SMA syndrome in patients who present with postprandial abdominal pain, vomiting, early satiety, and weight loss, especially if they have risk factors such as rapid weight loss, scoliosis, spinal surgery, or trauma.…”

Section: Introductionmentioning

confidence: 99%

“… 1 The incidence of SMA syndrome is estimated to be between 0.1% and 0.3%. 1 , 2 This case report highlights the importance of considering SMA syndrome in patients who present with postprandial abdominal pain, vomiting, early satiety, and weight loss, especially if they have risk factors such as rapid weight loss, scoliosis, spinal surgery, or trauma. 4 The diagnosis of SMA syndrome requires a high index of suspicion and correlation of clinical symptoms with radiographic findings.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Challenges and pitfalls in diagnosing superior mesenteric artery syndrome: A case report

Soqia,

Janoud,

Soukia

et al. 2024

SAGE Open Medical Case Reports

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Superior mesenteric artery syndrome is a rare condition that causes duodenal obstruction due to compression by the superior mesenteric artery and the aorta. It can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. The clinical presentation is nonspecific and often mimics other causes of upper gastrointestinal obstruction. The diagnosis requires a high index of suspicion and a correlation of clinical symptoms with radiographic findings. We report a case of a 17-year-old female patient who presented with chronic abdominal pain, vomiting, and weight loss. She was diagnosed with superior mesenteric artery syndrome based on an abdominal computed tomography scan that showed a reduced aortomesenteric angle of 30° and a reduced aortomesenteric distance of 7 mm. She was treated conservatively with anticoagulation therapy, dietary modification, and physical activity. She reported symptom improvement and weight gain after 2 weeks of treatment. This case illustrates the challenges and pitfalls in diagnosing superior mesenteric artery syndrome.

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Superior mesenteric artery syndrome in a 30-year-old male patient: A case report and literature review

Cited by 2 publications

References 18 publications

Massive Gastric Dilatation and Multi-Organ Ischemia Due to Superior Mesenteric Artery Syndrome: A Rare Case Report

Massive Gastric Dilatation and Multi-Organ Ischemia Due to Superior Mesenteric Artery Syndrome: A Rare Case Report

Challenges and pitfalls in diagnosing superior mesenteric artery syndrome: A case report

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