Superior mesenteric artery compression syndrome - case report

• Published in: Journal of Coloproctology 2011-12, Vol.31 (4), p.401-404
• Main Authors: França Neto, Paulo Rocha, Paiva, Rodrigo de Almeida, Lacerda Filho, Antônio, Queiroz, Fábio Lopes de, Noronha, Teon
• Format: Article
• Language: English
• Subjects: abdominal pain; diagnosis; diagnóstico; dor abdominal; duodeno; duodenum; GASTROENTEROLOGY & HEPATOLOGY; radiografia; radiography; superior mesenteric artery syndrome; SURGERY; síndrome da artéria mesentérica superior
• ISSN: 2317-6423; 2237-9363; 2317-6423
• DOI: 10.1590/S2237-93632011000400015

Superior mesenteric artery syndrome is an entity generally caused by the loss of the intervening mesenteric fat pad, resulting in compression of the third portion of the duodenum by the superior mesenteric artery. This article reports the case of a patient with irremovable metastatic adenocarcinoma in the sigmoid colon, that evolved with intense vomiting. Intestinal transit was carried out, which showed important gastric dilation extended until the third portion of the duodenum, compatible with superior mesenteric artery syndrome. Considering the patient's nutritional condition, the medical team opted for the conservative treatment. Four months after the surgery and conservative measures, the patient did not present vomiting after eating, maintaining previous weight. Superior mesenteric artery syndrome is uncommon and can have unspecific symptoms. Thus, high suspicion is required for the appropriate clinical adjustment. A barium examination is required to make the diagnosis. The treatment can initially require gastric decompression and hydration, besides reversal of weight loss through adequate nutrition. Surgery should be adopted only in case of clinical treatment failure.