Increase body weight to treat superior mesenteric artery syndrome

IntroductionSuperior mesenteric artery (SMA) syndrome is a rare cause of duodenal obstruction resulting from vascular compression of the third part of the duodenum in the angle between the abdominal aorta and SMA.Case presentationA 19-year-old woman with anorexia nervosa with upper gastrointestinal...

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Bibliographic Details
Published in:BMJ case reports 2017-06, Vol.2017, p.bcr-2017-219378
Main Authors: Albano, Miguel Nico, Costa Almeida, Carlos, Louro, João Mendes, Martinez, Guillermo
Format: Article
Language:English
Subjects:
Abdomen
Anorexia
Anorexia Nervosa - complications
Anorexia Nervosa - diagnosis
Coronary vessels
Duodenal Obstruction - complications
Duodenal Obstruction - diagnosis
Duodenal Obstruction - etiology
Duodenum - blood supply
Duodenum - pathology
Eating disorders
Europe (West)
Female
Gastrointestinal surgery
Humans
Medical imaging
Nutrition
Parenteral Nutrition, Total - methods
Patients
Rare Disease
Rare Diseases
Small intestine
Substance abuse treatment
Superior Mesenteric Artery Syndrome - diagnostic imaging
Superior Mesenteric Artery Syndrome - etiology
Superior Mesenteric Artery Syndrome - therapy
Tomography, X-Ray Computed
Treatment Outcome
Weight Gain - physiology
White
Young Adult
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Summary:IntroductionSuperior mesenteric artery (SMA) syndrome is a rare cause of duodenal obstruction resulting from vascular compression of the third part of the duodenum in the angle between the abdominal aorta and SMA.Case presentationA 19-year-old woman with anorexia nervosa with upper gastrointestinal obstruction symptoms resorted to the emergency department. A diagnosis of SMA syndrome was made. Symptoms were solved with conservative treatment aimed at increase body weight.DiscussionSMA syndrome is most commonly associated with debilitating illnesses. Patients present with acute or insidious upper gastrointestinal obstruction symptoms. Aortomesenteric artery angle of ≤25° is the most sensitive measure of diagnosis. Advances in both enteral and parenteral nutrition led to a shift towards conservative treatment.ConclusionsLow threshold of suspicion is important to make a timely diagnosis and treatment. A conservative treatment aimed at increasing body weight is the first-line approach, leaving surgical intervention for failure cases.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-219378