Acute abdominal pain caused by superior mesenteric artery syndrome in a healthy young boy

Nishiguchi, Sho; Shirobe, Takashi

doi:10.1136/bcr-2016-217512

Cited by 3 publications

(3 citation statements)

References 1 publication

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“…Changes like this in body composition can lead to a narrowing of the aortomesenteric space and angle due to a decrease in the mesenteric fat density. Therefore, this study adds to prior literature indicating that a growth spurt is a risk factor for SMA syndrome [3,5,6] Possible triggers for compression include additional weight loss due to infection [6] and excessive ingestion of food [7]. In the current case, this patient had a history of difficulty gaining weight and had ingested an excessive amount of food after moderate physical activity.…”

Section: Discussionmentioning

confidence: 54%

Superior Mesenteric Artery Syndrome in an Adolescent with No Significant Weight Loss: A Case Report

Grabar¹,

Berra²,

Andreeff

2021

AJPN

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This case report discusses a case of superior mesenteric artery (SMA) syndrome in a previously healthy 16-year-old male without significant weight loss or usual risk factors. This patient presented to the emergency department with 4 days of bilious vomiting and epigastric pain that started after ingestion of a large meal and intense exercise. During his illness he was seen at 3 different healthcare facilities before receiving a diagnosis at the fourth visit. SMA syndrome was initially suspected based on the location of obstruction on CT but was not confirmed until upper endoscopy was performed. In puberty, males have an increase in lean body mass with concurrent loss of adipose. With these changes, the angle between the aorta and the superior mesenteric artery can narrow with decrease in mesenteric fat.

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Section: Discussionmentioning

confidence: 54%

Superior Mesenteric Artery Syndrome in an Adolescent with No Significant Weight Loss: A Case Report

Grabar¹,

Berra²,

Andreeff

2021

AJPN

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“…Therefore, as previous studies indicate, a growth spurt is a risk factor for SMA syndrome,3 7–9 and any event that further exacerbates the narrowing of the aortomesenteric space is likely to result in a manifestation of SMA syndrome. Potential triggers identified thus far for such exacerbation include extra weight loss due to infection10 and overeating after dieting 11. In the present case, considering his linear growth without weight gain, the patient’s mesenteric fat tissue had already been depleted.…”

Section: Discussionmentioning

confidence: 72%

Superior mesenteric artery syndrome in a healthy active adolescent

Okamoto¹,

Sato

Sasaki

2019

BMJ Case Rep

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This report discusses a case of superior mesenteric artery (SMA) syndrome in a previously healthy 15-year-old boy with no weight loss or other common risk factors. The patient presented to the emergency department with acute bilious vomiting and epigastric pain after acute consumption of a meal and excessive quantities of water. The patient was diagnosed with SMA syndrome based on the findings of contrasted CT of the abdomen. In early puberty, boys have a significant increase in lean body mass and a concomitant loss of adipose tissues. These pubertal changes lead to a narrowing of the aortomesenteric space. The acute consumption of food and water caused a transient obstruction at the already-narrowed space, which resulted in the manifestation of SMA syndrome. This case demonstrates that pubertal growth spurt is a risk factor for SMA syndrome, and acute excessive ingestion can trigger SMA syndrome among those in puberty.

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“…Workup for SMAS in haemodynamically stable patients should involve targeted imaging, including CT angiography and abdominal ultrasound 16 17. However, in unstable patients, such as ours, a preoperative diagnosis of SMAS is not needed prior to operative intervention 18 19. In the OR, the diagnosis of SMAS was made on visual inspection and EGD evaluation.…”

Section: Discussionmentioning

confidence: 99%

Acute superior mesenteric artery syndrome complicated by severe gastric, pancreatic and renal ischaemia

Moore,

Eldredge,

Russell

2024

BMJ Case Rep

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Superior mesenteric artery syndrome (SMAS) is a rare and potentially life-threatening cause of small bowel obstruction in which the superior mesenteric artery impinges on the third portion of the duodenum. SMAS is typically encountered in patients with low body fat and a history of rapid weight loss and is often diagnosed as a chronic or subacute condition. Here, we describe a case of a healthy adolescent boy without typical SMAS prodromal symptoms presenting with a severe, hyperacute proximal small bowel obstruction due to SMAS. Complications arising from massive gastric and duodenal distension, including gastric, pancreatic and renal ischaemia, necessitated emergent surgical intervention consisting of the duodenojejunostomy bypass with partial gastric resection. The patient recovered without significant lasting consequences.

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Acute abdominal pain caused by superior mesenteric artery syndrome in a healthy young boy

Cited by 3 publications

References 1 publication

Superior Mesenteric Artery Syndrome in an Adolescent with No Significant Weight Loss: A Case Report

Superior Mesenteric Artery Syndrome in an Adolescent with No Significant Weight Loss: A Case Report

Superior mesenteric artery syndrome in a healthy active adolescent

Acute superior mesenteric artery syndrome complicated by severe gastric, pancreatic and renal ischaemia

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