Superior mesenteric artery syndrome caused by weight loss in a malnourished Syrian man

Aljarad, Ziad; Mahli, Nihad; Nasser, Mahmoud; Alobied, Majd; Alkhaled, Mamdouh; Alhussein, Mohamad; Alhamid, Ahmad; Mouakeh, Ahmad; Tarabishi, Ahmad Sankari

doi:10.1093/gastro/gox045

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…Although nausea, vomiting, recurrent postprandial pain, and bloating are the typical symptoms of this syndrome, the patient may have the manifestations of acute intestinal obstruction or chronic symptoms caused by intermittent bowel compression [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

Esmat

Najah

2021

Annals of Medicine &Amp; Surgery

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Introduction Superior mesenteric artery syndrome is a rare entity, caused by compression of the duodenum between the superior mesenteric artery and the aorta. Case presentation A 16-year-old male in the inpatient service of our hospital complained of vomiting for two weeks. The patient had a long hospital stay in our center for the management of trauma-related complications, which resulted in significant weight loss despite the parenteral nutrition as he was unable for taking the enteral nutrition due to severe facial traumatic injury. In oral contrast study, the proximal duodenal segments were dilated. The contrast media could not reach the duodenojejunal junction in the supine position, though a small amount of the contras passed the distal duodenal part on repositioning the patient to prone. On abdominal CT images, the angle and distance between the superior mesenteric artery and the abdominal aorta were decreased to 20. 8 0 , and 7.3 mm respectively. The findings were consistent with the superior mesenteric artery compression syndrome. He underwent a mini-laparotomy for the placement of a jejunostomy feeding tube aiming to promote weight gain and mesenteric fat restoration for preventing the SMA compression effects on the duodenum. Discussion The decrease in retroperitoneal fat owing to weight loss may result in aortomesenteric angle reduction and duodenal compression. Prompt nutritional support and timely diagnosis may preclude the need for more invasive surgical intervention. Conclusion Superior mesenteric artery syndrome is a rare condition, often resulting in small bowel obstruction. The clinical symptoms of this syndrome are nonspecific, which may underestimate the diagnosis. However, clinical suspicion supported by imaging study may help the accurate diagnosis. Superior mesenteric artery syndrome should be considered in all polytrauma and longstanding immobile patients present with rapid weight loss and vomiting.

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Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

Esmat

Najah

2021

Annals of Medicine &Amp; Surgery

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“…Patients typically present with abdominal pain, distension, tenderness, and vomiting. Other symptoms include abdominal hypersensitivity, weight loss, diarrhea, gastric reflux, feeding difficulties, and early satiety [9].…”

Section: Discussionmentioning

confidence: 99%

“…Severe burns, malignancy, anorexia nervosa, malabsorption, and hypermetabolic states are the predisposing conditions mentioned in SMAS [1, 9].…”

Section: Discussionmentioning

confidence: 99%

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Superior Mesenteric Artery Syndrome in a 6-Year-Old Girl with Final Diagnosis of Celiac Disease

Salehzadeh

Samadi

Mirzarahimi

2019

Case Reports in Gastrointestinal Medicine

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Background. Superior mesenteric artery syndrome (SMAS) occurs when the duodenum is compressed between the two arteries, superior mesenteric artery and aorta. The complications of this rarely found disorder in children range from causing trouble in duodenal functions to intestinal obstruction which is potentially life-threatening. Case Presentation. Here we are reporting a case of SMAS in a 6-year-old girl with the complaint of chronic abdominal pain since 3 years. She suffered from growth failure, while different workups were negative. Ultimately, imaging investigations detected superior mesenteric artery syndrome as an etiologic background. In the additional investigations, it is found that she suffered from celiac disease. Conclusion. We concluded that the inflammatory nature of the celiac disease can affect the anatomy of the duodenum beyond its mucosal surface in the mesenteric fat tissue and results in SMAS.

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“…2,3 It is a rare condition, and the exact incidence of SMAS is unknown but found in the literature ranging between 0.013 to 0.3%. 4 The pathophysiology of this syndrome is a complex entero-vascular disorder which is due to loss of fat pad. The third portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Wilkie's syndrome in an adolescent female patient

2020

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<p>One of the rare cases of the upper gastrointestinal tract obstruction is superior mesenteric artery syndrome (SMAS) but potentially life-threatening if not recognized early. It is due to loss of fat pad between the aorta and SMA which will lead to a compression of the third portion of the duodenum. It has a different angle which will lead to different presentations as well as severity. We are reporting the 15 year-old (y/o) female who is medically free, presented to the emergency department (ED) complaining of severe colicky epigastric abdominal pain for the last 5 days in the epigastric area. The diagnosis of SMAS was made after clinical and radiological investigation. After proper supportive resuscitative measures, definitive management of the surgery was done by laparoscopic approach (duodenojejunostomy). The diagnosis of SMA syndrome is considered challenging due to many presentations and might be confused with other clinical conditions. Unless early diagnosed and treated, the outcome might be catastrophic. Medical treatment is attempted first in many cases depending on the severity and presentation but if failed, surgery will be the best option.</p>

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Superior mesenteric artery syndrome caused by weight loss in a malnourished Syrian man

Cited by 4 publications

References 7 publications

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

Superior Mesenteric Artery Syndrome in a 6-Year-Old Girl with Final Diagnosis of Celiac Disease

Wilkie's syndrome in an adolescent female patient

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