Ansar Muhammad, Shahbaz Maham, Saleemi Abdul Nabi, Fox Bruce
Internal Medicine, University Hospitals Plymouth NHS Trust, Plymouth, GBR.
Radiology, University Hospitals Plymouth NHS Trust, Plymouth, GBR.
Cureus. 2024 Nov 4;16(11):e72996. doi: 10.7759/cureus.72996. eCollection 2024 Nov.
This is a case of a young lady who was admitted multiple times with complaints of inability to digest food and abdominal pain. She had nausea and vomiting for long periods and was unable to tolerate orally. As she was unable to tolerate oral feeding and losing weight, she was started on nasogastric feed (NG feed) and later percutaneous endoscopic gastrostomy (PEG) tube feeding because NG feed was uncomfortable for the patient and did not alleviate the problem. Clinicians decided to look for alternative causes and an esophagogastroduodenoscopy was performed but no cause was found. Later, fluoroscopy findings favored superior mesenteric artery syndrome. Thus, the feeding tube was changed to percutaneous endoscopic gastrointestinal-jejunal (PEG-J) tube feeding which helped her with her symptoms, and the patient improved clinically after some time and gained weight as well. This case highlights the significance of early suspicion and diagnosis of superior mesenteric artery syndrome. Timely recognition may lead to early diagnosis and management, saving patients from debilitating adverse events.
这是一位年轻女性的病例，她因消化不良和腹痛多次入院。她长期恶心呕吐，无法经口耐受。由于她无法耐受经口喂养且体重减轻，起初给予鼻饲（NG 喂养），但因患者感觉不适且问题未得到缓解，后来改为经皮内镜下胃造口术（PEG）管喂养。临床医生决定寻找其他病因，于是进行了食管胃十二指肠镜检查，但未发现病因。后来，透视检查结果提示为肠系膜上动脉综合征。因此，将喂养管改为经皮内镜下胃肠空肠造口术（PEG-J）管喂养，这有助于缓解她的症状，一段时间后患者临床症状改善，体重也有所增加。该病例凸显了早期怀疑和诊断肠系膜上动脉综合征的重要性。及时识别可能有助于早期诊断和管理，使患者避免出现严重的不良事件。
