Superior mesenteric artery syndrome: An unusual cause of abdominal compartment syndrome and bilateral lower limb ischemia.

Superior mesenteric artery (SMA) syndrome is a rare, unusual cause of proximal intestinal obstruction. It is characterized by compression of the third part of the duodenum secondary to narrowing of the anatomical space between the SMA and the aorta due to a loss of the intervening mesenteric fat pad. This case highlights the challenge in obtaining a pre-operative radiological diagnosis in an extreme case of gastric outlet obstruction in SMA syndrome, fatally complicated by ACS and bilateral lower limb ischemia. It demonstrates that SMA syndrome remains important to exclude especially in patients with rapid weight loss and cardinal symptoms of intestinal obstruction, often requiring a high index of clinical suspicion.