Presentation
Chronic abdominal pain with weight loss.
Patient Data
Abnormal reduction of the aortomesenteric distance (up to 4 mm) as well as the aortomesenteric angle (14 degrees). Following administration of oral contrast, the markedly attenuated third part of the duodenum passing between the abdominal aorta and superior mesenteric artery is well demonstrated being poorly filled with contrast. The rest of the study is unremarkable.
Case Discussion
Although the stomach and first two segments of the duodenum appear normal without dilatation, superior mesenteric artery syndrome may be responsible for the patient's symptoms. The presence of a reduced aortomesenteric distance and aortomesenteric angle in a young female with unexplained weight loss and anorexia makes this diagnosis possible.
Superior mesenteric artery syndrome has a slight female preponderance and is commonly seen between 10 and 39 years of age. On CT, the two crucial signs for diagnosis are a reduced aortomesenteric angle and an aortomesenteric distance of less than 8 mm.
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