Superior mesenteric artery syndrome in a patient with esophageal stenosis: A case report  

作　　者：Luise Cristina Torres Rubim de Barros Barbara Moreira Ribeiro Trindade dos Santos Gustavo de Sousa Arantes Ferreira Vitoria Mikaelly da Silva Gomes Lorenna Paulinelli Bahia Vieira 

机构地区：[1]Department of General Surgery,Hospital de Clinicas da Universidade Federal de Minas Gerais,Belo Horizonte 31710350,Minas Gerais,Brazil [2]Department of Liver Transplantation,Instituto de Cardiologia do Distrito Federal,Brasilia 70658-700,Distrito Federal,Brazil [3]Department of General Surgery,Hospital Metropolitano Doutor Celio de Castro,Belo Horizonte 30620090,Minas Gerais,Brazil

出　　处：《World Journal of Surgical Procedures》2022年第2期13-19,共7页世界外科手术杂志

摘　　要：BACKGROUND Superior mesenteric artery syndrome(SMAS)is a rare condition,characterized by duodenal obstruction caused by compression of its third part by the superior mesenteric artery(SMA).Most cases of SMAS are associated with weight loss,and the most frequent clinical manifestations are nausea,vomiting,postprandial fullness,and abdominal pain.Treatment of SMAS is usually conservative,consisting mainly of adequate nutritional support,but in refractory cases surgery may be necessary,with gastrojejunostomy and duodenojejunostomy being the most commonly performed procedures.CASE SUMMARY We describe the case of a man in his forties with a pre-existing diagnosis of esophageal stricture due to sodium hydroxide ingestion,who suffered significant weight loss after replacement of his jejunostomy tube.He was admitted to the hospital due to pain and abdominal distension.A computerized tomography scan showed significant distension of the stomach and duodenum with narrowing of the duodenum at the point at which it is crossed by the superior mesenteric artery,thus establishing the diagnosis of SMAS.Due to the presence of the esophageal stricture,the patient was incapable of emesis;however,passage of a nasogastric tube for decompression was not possible.Considering the risk of gastric perforation due to distention,we opted for surgical treatment in the form of a surgical gastrojejunostomy after which he showed complete resolution of all symptoms and was discharged from the hospital 5 d after the procedure.CONCLUSION Diagnosis of SMAS can be challenging in patients with esophageal stenosis,and risk of gastric perforation may preclude conservative treatment.

关 键 词：Superior mesenteric artery syndrome Duodenal obstruction Wilkie’s syndrome Esophageal stricture Esophageal stenosis Case report 

分 类 号：R57[医药卫生—消化系统]