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Superior mesenteric artery syndrome – a rare diagnosis for common upper gastrointestinal symptoms

Ammar MH Shehadeh, Mohammed Samir Mokhtar Hamed Elwan, Hazem Mohamed Mostafa Elfar
Scheduled to Publish in : HAMDAN MEDICAL JOURNAL ; Future Issues
DOI : 10.7707/hmj.616

Abstract


Superior mesenteric artery (SMA) syndrome is a rare acquired vascular compression disorder in which acute angulation of the SMA results in compression of the third part of the duodenum, leading to intestinal obstruction. This is typically caused by an angle of 625° between the abdominal aorta and the SMA, in comparison with the normal range of 3856°, as a result of a lack of retroperitoneal visceral fat (mesenteric fat). In addition, the aortomesenteric distance is 28mm as opposed to the typical 1020mm. Here we report the case of an 11-year-old girl who presented with frequent attacks of non-specific abdominal pain over a few years, who had been treated symptomatically without a clear diagnosis. However, in the last admission, she presented to our hospital with symptoms of subacute small bowel obstruction including bilious vomiting and epigastric pain that prompted extensive investigations including multislice abdominal computerized tomography with oral and intravenous contrast. This scan confirmed the diagnosis of SMA syndrome.

 


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