2000, Number 4
Cir Gen 2000; 22 (4)
García AJ, Pérez IA, Sánchez CRM, Luna OK
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ABSTRACTObjective: To present the clinical case of a patient with vascular occlusion of the duodenum or superior mesenteric artery syndrome (Wilkie’s syndrome).
Design: Description of the case.
Setting: Third level health care hospital
Case description: A female patient, 18 years old, with posprandial abdominal pain at the epigastric region, colic-type, without irradiation accompanied by nausea, posprandial vomiting, and weight loss. Laboratory tests included blood tests, seric electrolytes, liver function tests; all were normal. Esophageal-gastric series revealed an abrupt interruption in the contrast medium flow at the level of the junction of the second and third portion of the duodenum; endoscopy revealed slight pangastritis; axial computed tomography showed thinning of the duodenal portion behind the superior mesenteric artery, and the selective angiography documented a retromesenteric space of 10.5 mm with the aorta-mesenteric angle at minimal normal levels. The patient was subjected to surgery, performing a latero-lateral duodenum-jejunum anastomosis; evolution was satisfactory.
Conclusion: The superior mesenteric syndrome is an infrequent alteration, its treatment is controversial. The most recommended procedure is to shunt the pre-stenotic portion of the duodenum to the jejunum.