The Identification of Superior Mesenteric Artery Syndrome Established by Endoscopic Ultrasound in a Patient with Severe Gastroptosis.
- Author:
Sung Jun KIM
1
;
Woo Chul CHUNG
;
Sung Hoon JUNG
;
Jae Wuk KWAK
;
Myung Hyun LEE
;
Chang Nyol PAIK
;
Kang Moon LEE
Author Information
1. Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. jwchulkr@yahoo.co.kr
- Publication Type:Case Report
- Keywords:
Superior mesenteric artery syndrome;
Endoscopic ultrasound
- MeSH:
Aorta;
Barium;
Bile;
Deglutition;
Duodenum;
Emergencies;
Female;
Fluoroscopy;
Humans;
Mesenteric Artery, Superior;
Nausea;
Stomach;
Superior Mesenteric Artery Syndrome;
Tomography, Spiral Computed;
Vomiting;
Weight Loss
- From:Korean Journal of Gastrointestinal Endoscopy
2010;40(2):121-125
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Superior mesenteric artery (SMA) syndrome is caused by compression of the transverse part of the duodenum between the SMA and the aorta, where the distance between these vessels decreases with loss of mesenteric fat. It occurs most frequently in patients with rapid weight loss. Conventionally, the diagnosis is established by digital fluoroscopy and contrast-enhanced spiral computed tomography (CT). A 17-year old woman was admitted via the emergency department with postprandial fullness, nausea, and bile stained vomiting. The initial radiological examination revealed severe gastroptosis. Fluoroscopic evaluation after barium swallowing failed due to a markedly distended stomach. The diagnosis of SMA syndrome was made by endoscopic ultrasound (EUS) using a mini-probe. EUS findings were in good agreement with the CT angiogram. A conservative trial was attempted, but symptoms remained refractory. Surgery was an alternative option and we treated the patient successfully with laparoscopic duodeno-jejunostomy.
