Superior mesenteric artery syndrome: A rare but life threatening disease

Abstract

Superior mesenteric artery syndrome was observed in an adolescent patient. He had a 1-day history of nausea, vomiting, and abdominal pain, without chronic or recurrent symptoms. Diagnosis was established by abdominal plain x-ray, contrast enhanced abdominal computed tomography, and endoscopic examination. The patient was hospitalized, monitorized, and decompressed by nasogastric tube without oral feeding. The symptoms of the patient were gradually relieved by conservative treatment and he was discharged after one week. Clinicians should be careful when facing upper gastrointestinal symptoms that are resistant and non-responsive to treatment, and this syndrome should be kept in mind. This case is presented to draw attention to this disease because of its rare incidence.

Fig. 1

Abdominal X-ray revealed a distended stomach reaching the iliac level, and the walls of stomach and duodenal bulb were widened with air-fluid levels. Linear portal venous gas images were remarked by an arrow in the hepatic region.

Fig. 2

The abdominal CT revealed a dilatation of distal esophagus (A: First axial section), prominent distention of stomach that reaches the pelvis (D: Sagittal section), dilatation of the first three portions of duodenum (C: Coronal section), an obstructed third duodenal portion between SMA and abdominal aorta (B: Second axial section). The contrast enhanced CT revealed the presence of intramural air in the wall of stomach and portal vein (B, C, and D).