Abstract
A previously healthy 15-year-old boy who participated in Ramadan and recently suffered from a gastro-enteritis presented at the emergency room with abdominal pain, vomiting, and marked weight loss. Abdominal X-ray and computed tomography showed upper gastrointestinal obstruction and narrowing of the distance between superior mesenteric artery and aorta abdominalis. Through these findings, superior mesenteric artery syndrome was diagnosed. Treatment consisted of placement of a nasojejunal tube for enteral feeding until weight gain was substantial. Superior mesenteric artery syndrome is rare, with a prevalence varying between 0.013 and 0.3 %. It is characterized by compression of the third part of duodenum between aorta and superior mesenteric artery, thus causing signs and symptoms of upper gastrointestinal obstruction. Conclusion: In general, when signs and symptoms of upper gastrointestinal obstruction are accompanied with rapid weight loss, superior mesenteric artery syndrome should be considered.
Similar content being viewed by others
References
Ahmed AR, Taylor I (1997) Superior mesenteric artery syndrome. Postgrad Med J 73(866):776–778
Biank V, Werlin S (2006) Superior mesenteric artery syndrome in children: a 20-year experience. Journal of pediatric gastroenterology and nutrition 42(5):522–525. doi:10.1097/01.mpg.0000221888.36501.f2
Kurbegov A, Grabb B, Bealer J (2010) Superior mesenteric artery syndrome in a 16-year-old with bilious emesis. Curr Opin Pediatr 22(5):664–667
Merrett ND, Wilson RB, Cosman P, Biankin AV (2009) Superior mesenteric artery syndrome: diagnosis and treatment strategies. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract 13(2):287–292. doi:10.1007/s11605-008-0695-4
Okugawa Y, Inoue M, Uchida K, Kawamoto A, Koike Y, Yasuda H, Otake K, Miki C, Kusunoki M (2007) Superior mesenteric artery syndrome in an infant: case report and literature review. Journal of pediatric surgery 42(10):E5–E8. doi:10.1016/j.jpedsurg.2007.07.002
Ozkurt H, Cenker MM, Bas N, Erturk SM, Basak M (2007) Measurement of the distance and angle between the aorta and superior mesenteric artery: normal values in different BMI categories. Surgical and radiologic anatomy: SRA 29(7):595–599. doi:10.1007/s00276-007-0238-9
Shiu JR, Chao HC, Luo CC, Lai MW, Kong MS, Chen SY, Chen CC, Wang CJ (2010) Clinical and nutritional outcomes in children with idiopathic superior mesenteric artery syndrome. J Pediatr Gastroenterol Nutr 51(2):177–182
Welsch T, Buchler MW, Kienle P (2007) Recalling superior mesenteric artery syndrome. Digestive surgery 24(3):149–156. doi:10.1159/000102097
Conflict of interest
All authors participated significantly in the preparation of this manuscript. The presented manuscript has been approved by all authors, has not been published previously, and is not under consideration for publication elsewhere. We certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bakker, M.E.C., van Delft, R., Vaessens, N.A.L. et al. Superior mesenteric artery syndrome in a 15-year-old boy during Ramadan. Eur J Pediatr 173, 1619–1621 (2014). https://doi.org/10.1007/s00431-013-2190-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-013-2190-5