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Case Reports
. 2010 Aug;2(8):392-4.
doi: 10.4297/najms.2010.2392.

Superior mesenteric artery syndrome: A case report

Rikki Singal  1 , Pradeep Kumar Sahu, Mukesh Goel, Samita Gupta, Raman Gupta, Anupama Gupta, Manmit Singh Sekhon, Sunder Lal Goyal
Affiliations
Case Reports

Superior mesenteric artery syndrome: A case report

Rikki Singal et al. N Am J Med Sci. 2010 Aug.

Abstract

Context: Superior mesenteric artery syndrome is a life- threatening upper gastrointestinal disorder due to compression of duodenum as it poses a difficult diagnostic dilemma. Third part of duodenum is in fixed compartment bounded anteriorly by the root of mesentery and superior mesentery artery and posteriorly by the aorta and lumbar spine. On barium contrast study and abdominal computerized tomography (CT) showed the dilatation of second part of duodenum and compression of the third part of duodenum between aorta and superior mesentery artery.

Case report: A 22 year young asthenic man admitted with the complaint of recurrent abdominal pain, epigastric fullness, and vomiting and weight loss. Abdominal examination revealed epigastric fullness and hyper peristaltic bowel sounds. Upper gastrointestinal barium study showed a dilated stomach with dilated second part of the duodenum and cut off at the third part of duodenum with no intrinsic mucosal abnormalities. There was no relief of obstruction in the left lateral decubitus or prone position. Conservative treatment was tried for one month but failed. Intra-operative findings confirmed the extrinsic obstruction of third part of duodenum with distension of 2(nd) part. A retrocolic duodenojejunostomy, side to side anastomosis done. In post-operative follow up, patient was symptom free.

Conclusion: Superior mesentery artery syndrome is a life threatening disease. It should be treated as soon as possible. Conservative trial can be given but Surgery is the treatment of the choice.

Keywords: Chronic; cast syndrome; duodenal ileus; obstruction; superior mesentery; surgery.

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Figures

Fig. 1
Fig. 1
Barium meal follow through X-ray showed dilatation of the second part of duodenum with compression of the third part.
Figs. 2a & 2b
Figs. 2a & 2b
Contrast enhanced computed tomography of the abdomen revealed compression of third part of the duodenum between superior mesentery artery and aorta.
See this image and copyright information in PMC

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