Suárez GR, Jiménez UPS, Castañeda ORA, Sánchez MVJ, García GJL

Language: Spanish
References: 12
Page: 51-55
PDF size: 116.24 Kb.

ABSTRACT

Superior mesenteric artery syndrome is characterized by acute massive gastric and duodenal dilatation. The superior mesenteric artery and “nutcracker syndrome” are a rare cause of upper gastrointestinal obstruction in children and adults. Wilkie first reported it in 1921. The condition arises as a result of mechanical obstruction of the third portion of the duodenum by the superior mesenteric artery just distal to its origin from the abdominal aorta. Typical presentation is with symptoms and signs of acute or chronic duodenal obstruction. We report the case of a boy with acute massive gastric and duodenal dilatation. A 14 year-old boy presented with acute massive gastric dilatation secondary to duodenal obstruction by the superior mesenteric artery. With uncharacterized developmental delay and presented with a 1-year history of general malaise, irritability, upper abdominal pain and vomiting. Upper gastrointestinal contrast study showed an abrupt obstruction in the third portion of the duodenum. During laparotomy, the stomach and proximal duodenum were noted to be grossly distended. A proximal loop of jejunum was anastomosed to the duodenum. The patient subsequently gained 4 kg in body weight, and the pain was controlled satisfactorily over the next 12 months. The major risk factors for development of superior mesenteric artery syndrome are rapid weight loss and surgical correction of spinal deformities. The clinical presentation of superior mesenteric artery syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss. The diagnosis is based on radiographic findings of duodenal compression by the superior mesenteric artery syndrome.

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