Superior mesentric artery syndrome

Case contributed by Dr Michael P Hartung

Presentation

Vomiting and weight loss for 5 years.

Patient Data

Age: 20 years
Gender: Female

Oral contrast was administered

CT

Mildly distended stomach. Markedly distended second portion of the duodenum, with tapering of the third portion as it passes under the superior mesenteric artery.

Fluoroscopy

Similar findings of mild gastric distention with more pronounced, moderate to severe dilation of the second portion of the duodenum, tapering as it crosses midline.

Case Discussion

Typical CT and fluoroscopic appearance of superior mesenteric artery syndrome, which occurs when there is extrinsic compression of the third portion of the duodenum due to a narrowed aortomesenteric angle. 

This patient had a long treatment course which was complicated by infection from parenteric nutrition, eventually undergoing duodenojejunostomy to relieve symptoms.

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