Lege Artis Medicinae

[Enigma abdominalis - superior mesenteric artery syndrome]

SCHNABEL Róbert1, G. TÓTH Kinga2, BIRKÁS Dezső3, PALIK Éva4, BOGNÁR Gábor5

JUNE 10, 2009

Lege Artis Medicinae - 2009;19(04-05)

[INTRODUCTION - Superior mesenteric artery syndrome is caused by vascular compression of the inferior transverse part of the duodenum due to the anomalous course of the superior mesenteric artery and/or a cranial shortening of the ligament of Treitz. Clinical caracteristics include postprandial epigastric pain, nausea, vomiting of bile, slow passage in the gastroduodenal passage, and as a consequence of the above, pernicious weight loss. CASE REPORT - In the case of a 35-year old woman with chronic abdominal symptoms for 6 years and 20 kg weight loss, CT-enterography revealed superior mesenteric artery syndrome. We identified an abnormally acute aortomesenteric angle of 7.3 degrees and a highly inserted ligament of Treitz as predisposing factors. We presume that the immediate cause of the development of severe vascular compression, in the case of our patient, was progressive weight loss due to a persistent Epstein-Barr virus infection. CONCLUSION - First in Hungarian literature we review the etiology, the radiological signs, the procedure of differential diagnosis, and the treatment options of superior mesenteric artery syndrome.]

AFFILIATIONS

  1. Fôvárosi Önkormányzat Nyírô Gyula Kórháza, II. Belgyógyászati Osztály, Budapest
  2. Eötvös Loránd Tudományegyetem, Pszichológiai Intézet
  3. Semmelweis Egyetem, Budapest, Pszichiátriai Klinikai Csoport
  4. Semmelweis Egyetem, Budapest, III. Belgyógyászati Klinika
  5. Semmelweis Egyetem, Budapest, II. Sebészeti Klinika

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