Korean J Med.  2009 Jun;76(6):727-731.

A case of superior mesenteric artery syndrome with hematemesis

• Moon SW
• Park H
• Mun JS
• Myoung BH
• Kim DH
• Kim HD
• Han C

Abstract

Superior mesenteric artery (SMA) syndrome is a rare disorder, characterized by compression of the third segment of the duodenum by the mesenteric artery at the level of the SMA, resulting in duodenal dilatation. The most characteristic symptoms are postprandial epigastric pain, fullness, voluminous vomiting, and eructation. The diagnosis may be difficult, but can be confirmed by upper gastrointestinal (UGI) contrast studies. We report a case of SMA syndrome in a 66-year-old patient with hematemesis. Endoscopy showed deep circular ulcerations with bleeding in the distal esophagus. Computed tomography (CT) and an UGI contrast series revealed distension of the stomach and duodenum, with a cut-off in the third portion of the duodenum. We treated the patient conservatively, but the patient's symptoms did not improve. Ultimately, the patient underwent successful gastrojejunostomy with a favorable postoperative outcome.

Keyword

Superior mesenteric artery syndrome; Hematemesis; Upper gastrointestinal tract obstruction

MeSH Terms

Aged
Dilatation
Duodenum
Endoscopy
Eructation
Esophagus
Gastric Bypass
Hematemesis
Hemorrhage
Humans
Mesenteric Arteries
Mesenteric Artery, Superior
Stomach
Superior Mesenteric Artery Syndrome
Ulcer
Vomiting