Superior Mesenteric Artery Syndrome: Delayed Diagnosis of a Rare Clinical Entity With a Common Clinical Presentation

Abstract

Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is an uncommon disorder that involves a set of symptoms that primarily includes postprandial pain at times associated with intestinal obstruction. Although a rare disease in the general population, SMA syndrome has a high probability of occurrence in patients who are severely malnourished or have certain debilitating conditions leading to a loss of retroperitoneal fat. Here, we present the case of a 16-year-old male with a one-year history of postprandial abdominal pain associated with nausea, multiple episodes of vomiting, and abdominal distension. Amid a delayed diagnosis and multiple hospital visits, the patient's condition further deteriorated. Thereafter, computed tomography of the abdomen confirmed this rare diagnosis. Because the patient could not be further managed conservatively, laparoscopic duodenojejunostomy was planned and done. This case report highlights the various challenges in diagnosing this disease and highlights the importance of an early diagnosis so that patients can be managed effectively and timely.

Superior mesenteric artery syndrome in an 8-year-old boy: a case report

“…The reason for the development of SMAS in children without weight loss is currently unexplained [ 5 ]. Another etiology that has been accused of causing this syndrome is spinal surgeries such as corrective surgery for scoliosis [ 10 ]. The clinical presentation of SMA syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss [ 11 ].…”

“…This could result in a delay in proper diagnosis and treatment. Other differential diagnoses that should be considered besides SMAS include intestinal malrotation, para-duodenal hernias, bezoars, pancreatitis, duodenitis, peptic ulcer disease, and Crohn's disease [ 10 ]. However, due to the rarity of the superior mesenteric artery syndrome, there is often a delay in diagnosis.…”

Medium-term results of laparoscopic lateral duodenojejunostomy for pediatric superior mesenteric artery compression syndrome

“…Since then, more and more LLDs have been performed successfully. Up to now, we have identi ed 18 cases (Table 1 [9,[18][19][20][21][22][23][24][25][26][27][28][29][30][31]) of laparoscopic techniques employed in children (< 18 years): 12 LLD cases, 4 laparoscopic Ladd's procedure cases, 2 laparoscopic Roux-en-Y duodenojejunostomy cases and 1 laparoscopic duodenum lysis case. These procedures have the bene ts of rapid recovery, functional improvement in bowel motility and the patient's health, decreased chances of small bowel adhesions and postoperative incisional hernia, minimum blood loss, less pain postoperatively, and, good cosmetic outcomes.…”

Superior Mesenteric Artery Syndrome: A Report of a Rare Case

“…Intestinal obstruction due to the compression of the third part of the duodenum by SMA and abdominal aorta is a controversial entity [ 3 - 6 ]. Not all patients experience serious gastrointestinal (GI) symptoms such as pain, vomiting, constipation, and abdominal distention; however, most patients experience the above symptoms over a long period of time [ 7 ]. Therefore, both clinical and radiological data are helpful in the diagnosis [ 1 ].…”