Korean J Helicobacter Up Gastrointest Res.  2014 Dec;14(4):268-272. 10.7704/kjhugr.2014.14.4.268.

Superior Mesenteric Artery Syndrome with Massive Gastric Dilatation

• Lee HJ
• Park SY
• Kim HG
• Park CH
• Kim HS
• Choi SK
• Rew JS

• KMID: 2305130
• DOI: http://doi.org/10.7704/kjhugr.2014.14.4.268

Abstract

Superior mesenteric artery (SMA) syndrome is a rare disorder characterized by extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and aorta, resulting in intermittent obstruction, thereby resulting in proximal duodenal and stomach dilatation. Although the most characteristic symptoms are postprandial epigastric pain, fullness, voluminous vomiting, and eructation, severe symptoms including acute massive gastric dilatation to the extent of surgical abdomen was rarely reported. We report a case of SMA syndrome in a 24-year-old patient with an eating disorder. CT and an upper gastointestinal contrast series revealed massive gastric dilatation which induced vascular compressions. Endoscopy showed deep extensive ulcerations of the whole stomach with duodenal necrosis and ischemia, which prompted immediate surgical laparotomy, but no remarkable intra-abdominal peritonitis evidence was noted. We treated the patient conservatively and the patient recovered from all the symptoms.

Keyword

Superior mesenteric artery syndrome; Eating disorders; Gastric dilatation

MeSH Terms

Abdomen
Aorta
Duodenum
Feeding and Eating Disorders
Endoscopy
Eructation
Gastric Dilatation*
Humans
Ischemia
Laparotomy
Mesenteric Artery, Superior
Necrosis
Peritonitis
Stomach
Superior Mesenteric Artery Syndrome*
Ulcer
Vomiting
Young Adult