Superior Mesenteric Artery Syndrome: Weight Loss Can Be a Problem, Weight Gain Can Be a Solution

Abstract

Introduction: Superior mesenteric artery syndrome (SMAS) is a rare acquired disorder, which in the present case had an acute and unusual way of presentation. Case Report: We present a 17-year-old female with nausea, vomiting, and intense epigastric pain. In the previous 6 months, she had lost 42% of her body weight. The echography showed a distended stomach that reached the pelvis, and the nasogastric tube that was placed drained 2,000 mL. A computed tomography scan confirmed the SMAS diagnosis. She started a hypercaloric fractionated meal diet, prokinetics, and postural measures. After the 1-year follow-up the patient is asymptomatic. Conclusion: This acute presentation is rare but life-threatening due to the possibility of gastric rupture. Medical management is possible in the majority of cases, and surgery is needed only in the refractory ones.

Unusual presentation of superior mesenteric artery syndrome in a child

“…Prokinetic drugs can be added to improve motility and enhance stomach emptying. Despite all measures, greater than 75% of patients eventually require surgical intervention 13…”

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

“…The duodenojejunostomy is a relatively simple procedure with a success rate of 80–90%. However, current data in the literature do not support one surgical procedure over another as no randomized trials are available [ 13 , 20 ]. In our case, the conservative management was not successful.…”

Relato de caso de Síndrome de Wilkie / Case Report of Wilkie's Syndrome

“…A síndrome deixa a aorta no nível da primeira vertebra lombar criando um ângulo agudo pelo qual passa o duodeno. Quando o ângulo mede menos de 20° os sintomas causados pela compressão duodenal e consequente oclusão intestinal aparecem 6 . Sua sintomatologia é variável e inespecífica, manifesta-se mais frequentemente por dor abdominal e enfartamento pós-prandial, náuseas e vômitos biliares, saciedade precoce, anorexia e consequentemente perda ponderal 7 .…”