Alvarenga Ana, Espinheira Céu, Guerra Paula, Garcia Maria, Abreu Mariana, Campos Miguel
Pediatric Surgery Department, Centro Hospitalar São João, Porto, Portugal.
Pediatric Department, Centro Hospitalar São João, Porto, Portugal.
GE Port J Gastroenterol. 2017 Jan;24(1):43-46. doi: 10.1159/000450898. Epub 2016 Nov 24.
Superior mesenteric artery syndrome (SMAS) is a rare acquired disorder, which in the present case had an acute and unusual way of presentation.
We present a 17-year-old female with nausea, vomiting, and intense epigastric pain. In the previous 6 months, she had lost 42% of her body weight. The echography showed a distended stomach that reached the pelvis, and the nasogastric tube that was placed drained 2,000 mL. A computed tomography scan confirmed the SMAS diagnosis. She started a hypercaloric fractionated meal diet, prokinetics, and postural measures. After the 1-year follow-up the patient is asymptomatic.
This acute presentation is rare but life-threatening due to the possibility of gastric rupture. Medical management is possible in the majority of cases, and surgery is needed only in the refractory ones.
