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Korean J Gastrointest Endosc. 2008 Oct;37(4):271-275. Korean. Case Report.
Kang MK , Kwon CI , Lee JE , Kim YH , Ko KH , Hong SP , Park PW , Kim HJ .
Department of Internal Medicine, College of Medicine,Pochon CHA University, Seongnam, Korea.
Department of Radiology, College of Medicine,Pochon CHA University, Seongnam, Korea.

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.

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