Korean J Med.  2012 Nov;83(5):613-618.

Superior Mesenteric Artery Syndrome with Nutcracker Syndrome in a Patient with Type 1 Diabetes Mellitus

• Kim SH
• Heo JU
• Tang YK
• Kim JH
• Shu YC
• Kim KT
• Byun JR

Abstract

Superior mesenteric artery (SMA) syndrome is an uncommon cause of a proximal intestinal obstruction. The most characteristic symptoms are postprandial fullness, nausea, and vomiting. The diagnosis is established by ultrasonography and contrast-enhanced computed tomography. Almost all patients respond well to conservative management. However, if conservative management fails, surgical options should be applied. In this article, we report a case of SMA syndrome with Nutcracker syndrome in a patient with diabetes mellitus. Establishing the diagnosis of Nutcracker syndrome is usually based on clinical suspicion and radiological findings. Several complications that have been reported to result from SMA syndrome include peptic ulcer disease, pancreatitis, metabolic alkalosis, and uremic syndrome. However, Nutcracker syndrome accompanied by SMA syndrome is extremely uncommon, as described in this case. To our knowledge, this association has not been reported previously.

Keyword

Superior mesenteric artery syndrome; Nutcracker syndrome; Diabetes mellitus

MeSH Terms

Alkalosis
Diabetes Mellitus
Diabetes Mellitus, Type 1
Humans
Intestinal Obstruction
Mesenteric Artery, Superior
Nausea
Pancreatitis
Peptic Ulcer
Superior Mesenteric Artery Syndrome
Vomiting