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肠系膜上动脉综合征合并腹部结核:令人警醒的病例

Superior Mesenteric Artery Syndrome in association with Abdominal Tuberculosis: An Eye Opener.

作者信息

Bhatt Shuchi, Mishra Biswajit, Tandon Anupama, Manchanda Smita, Parthsarathy G

机构信息

Department of Radiodiagnosis, University College of Medical Sciences and GTB Hospital, Dilshad Garden, New Delhi, India.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Malays J Med Sci. 2017 May;24(3):96-100. doi: 10.21315/mjms2017.24.3.12. Epub 2017 Jun 30.

Abstract

Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge. Therefore, an unknown cause (SMAS) of upper gastrointestinal obstruction in a patient of abdominal tuberculosis is being presented for the first time through this case report. An imaging diagnosis of SMAS was made on contrast enhanced CT abdomen which also confirmed the clinical suspicion of abdominal tuberculosis in the patient. The patient was managed conservatively and recovered without requiring any surgical intervention for the obstructive symptoms.

摘要

肠系膜上动脉综合征(SMAS)是一种罕见的临床病症,表现为急性或慢性上消化道梗阻。它是由于腹主动脉与覆盖其上的肠系膜上动脉之间十二指肠第三部受压所致,这是由两血管夹角减小引起的。在导致严重体重减轻的情况下,腹膜后脂肪迅速流失是导致该病症的主要因素。据我们所知,此前尚未有肠系膜上动脉综合征与腹部结核相关的报道。因此,本文通过该病例报告首次呈现了一名腹部结核患者上消化道梗阻的不明病因(SMAS)。通过腹部增强CT做出了SMAS的影像学诊断,这也证实了患者腹部结核的临床怀疑。患者接受了保守治疗,梗阻症状无需任何手术干预即康复。

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