Superior Mesenteric Artery Syndrome in Type 1 Diabetes Masquerading as Gastroparesis

Abstract

OBJECTIVE—To describe and discuss a case of superior mesenteric artery syndrome (SMAS) presenting with gastrointestinal signs and symptoms mistakenly attributed to, and treated as, diabetic gastroparesis. RESEARCH DESIGN AND METHODS—A case report was compiled describing the clinical presentation, including history and physical examination, evaluation, diagnosis, and treatment of a patient with type 1 diabetes presenting with gastrointestinal complications. RESULTS—Clinical suspicion combined with the appropriate radiological evaluation led to a diagnosis of SMAS, with classic findings of reduced aortomesenteric angle and distance. Surgical intervention resulted in resolution of symptoms and recovery of glycemic control. CONCLUSIONS—The possibility of SMAS should be considered in patients with type 1 diabetes presenting with gastrointestinal symptomatology, especially when associated with weight loss.