Challenges and pitfalls in diagnosing superior mesenteric artery syndrome: A case report

Author:

Soqia Jameel1ORCID,Janoud Omran1ORCID,Soukia Ali2,Saadoun Rakan345,Mousa Khaled1

Affiliation:

1. Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic

2. Faculty of Medicine, University of Kalamoon, Deir Atieh, Syrian Arab Republic

3. Ruprecht Karls University Heidelberg, Medical Faculty Mannheim, Germany

4. Department of Otorhinolaryngology-Head and Neck Surgery, Mannheim Medical Center, Mannheim, Germany

5. The University of Pittsburgh, Department of Plastic Surgery, Pittsburgh, USA

Abstract

Superior mesenteric artery syndrome is a rare condition that causes duodenal obstruction due to compression by the superior mesenteric artery and the aorta. It can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. The clinical presentation is nonspecific and often mimics other causes of upper gastrointestinal obstruction. The diagnosis requires a high index of suspicion and a correlation of clinical symptoms with radiographic findings. We report a case of a 17-year-old female patient who presented with chronic abdominal pain, vomiting, and weight loss. She was diagnosed with superior mesenteric artery syndrome based on an abdominal computed tomography scan that showed a reduced aortomesenteric angle of 30° and a reduced aortomesenteric distance of 7 mm. She was treated conservatively with anticoagulation therapy, dietary modification, and physical activity. She reported symptom improvement and weight gain after 2 weeks of treatment. This case illustrates the challenges and pitfalls in diagnosing superior mesenteric artery syndrome.

Publisher

SAGE Publications

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