Okamoto Tsuyoshi, Sato Takumi, Sasaki Yukio
Pediatric Intensive Care Unit, Nagano Children's Hospital, Azumino, Japan.
Department of Pediatrics, Hirosaki National Hospital, Hirosaki, Japan.
BMJ Case Rep. 2019 Aug 26;12(8):e228758. doi: 10.1136/bcr-2018-228758.
This report discusses a case of superior mesenteric artery (SMA) syndrome in a previously healthy 15-year-old boy with no weight loss or other common risk factors. The patient presented to the emergency department with acute bilious vomiting and epigastric pain after acute consumption of a meal and excessive quantities of water. The patient was diagnosed with SMA syndrome based on the findings of contrasted CT of the abdomen. In early puberty, boys have a significant increase in lean body mass and a concomitant loss of adipose tissues. These pubertal changes lead to a narrowing of the aortomesenteric space. The acute consumption of food and water caused a transient obstruction at the already-narrowed space, which resulted in the manifestation of SMA syndrome. This case demonstrates that pubertal growth spurt is a risk factor for SMA syndrome, and acute excessive ingestion can trigger SMA syndrome among those in puberty.
本报告讨论了一例肠系膜上动脉（SMA）综合征病例，患者为一名15岁此前健康的男孩，无体重减轻或其他常见风险因素。该患者在急性进食一顿饭并饮用过量水后，因急性胆汁性呕吐和上腹部疼痛就诊于急诊科。根据腹部增强CT检查结果，该患者被诊断为SMA综合征。在青春期早期，男孩的瘦体重显著增加，同时脂肪组织减少。这些青春期变化导致主动脉肠系膜间隙变窄。急性进食和饮水导致在已经变窄的间隙处出现短暂梗阻，从而导致SMA综合征的表现。该病例表明青春期生长突增是SMA综合征的一个风险因素，急性过量摄入可在青春期人群中引发SMA综合征。
