Superior mesenteric artery syndrome in a healthy adolescent

Description

A 12-year-old, previously healthy, girl presented to our hospital with a 3-day history of epigastric pain and vomiting. She also reported having frequent epigastric pain for the past 2 years. Physical examination revealed a body mass index of 13.5 kg/m² and abdominal distension. Abdominal contrast-enhanced CT revealed a bloated stomach and a sandwiched horizontal portion of the duodenum between the aorta and superior mesenteric artery (SMA). The angle between the aorta and SMA was 17°, and the aorta–SMA distance was 5.2 mm (figure 1A,B), which met the diagnostic imaging adult criteria for SMA syndrome (SMAS).1 An upper gastrointestinal series also revealed that the contrast agent smoothly reached the proximal duodenum, but stopped at the horizontal portion of the duodenum where stenosis was suspected based on CT (figure 1C). Decompression using a nasogastric tube improved her clinical symptoms, and she was discharged. SMAS is characterised by...

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