Superior mesenteric artery syndrome

Case contributed by Pol Picart Royo
Diagnosis almost certain

Presentation

Postprandial epigastric pain of 6 months' evolution that improves in prone and left lateral decubitus. Associated with non-voluntary weight loss.

Patient Data

Age: 25 years
Gender: Female

Second portion of the duodenum slightly dilated, with compression of the third portion of duodenum by the superior mesenteric artery and an aortomesenteric angle < 20º.

These findings are compatible with Wilkie's syndrome, given the symptomatology refferred by the patient.

A stenosis of the left renal vein by the aortomesenteric clamp is also observed.

Case Discussion

These radiological findings associated with the symptomatology referred by the patient led to the diagnosis of Wilkie's syndrome.

The patient was treated conservatively and months later reported improvement in abdominal pain with weight gain after months of forced feeding.

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