Korean J Gastrointest Endosc.  2008 Oct;37(4):271-275.

A Case of a Gastric Bezoar Combined with Superior Mesenteric Artery Syndrome

• Kang MK
• Kwon CI
• Lee JE
• Kim YH
• Ko KH
• Hong SP
• Park PW
• Kim HJ

Abstract

Superior mesenteric artery syndrome is caused by compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta. Recently, we experienced a case of a gastric bezoar combined with SMA syndrome. A 58-year-old man presented with upper abdominal pain, bloating and weight loss of 5 kg. An endoscopic examination identified a huge gastric bezoar. The bezoar was broken and fragmented into small pieces using an argon plasma coagulator and endoscopic snare catheter. Hypotonic duodenography showed a longitudinal linear band that was presumed to be a vascular impression of the third portion of the duodenum and contrast-enhanced spiral CT showed a reduced distance of 8.4 mm but a normal angle of 38.5degrees between the arota and the SMA. A second endoscopic examination demonstrated prominent pulsations that compressed the duodenal wall at the third portion. Luminal expansion with full inflation of air was not attempted under endoscopy.

Keyword

SMA syndrome; Bezoar; Argon plasma coagulation

MeSH Terms

Abdominal Pain
Aorta
Argon
Argon Plasma Coagulation
Bezoars
Catheters
Duodenum
Endoscopy
Humans
Inflation, Economic
Mesenteric Artery, Superior
Middle Aged
Phenobarbital
Plasma
SNARE Proteins
Superior Mesenteric Artery Syndrome
Tomography, Spiral Computed
Weight Loss
Argon
Phenobarbital
SNARE Proteins