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KMID : 0359020080370040271
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Korean Journal of Gastrointestinal Endoscopy
2008 Volume.37 No. 4 p.271 ~ p.275
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A Case of a Gastric Bezoar Combined with Superior Mesenteric Artery Syndrome
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Kang Min-Kyoung
Kwon Chang-Il
Ko Kwang-Hyun
Hong Sung-Pyo
Park Pil-Won
Kim Yong-Hun
Lee Ji-Eun
Kim Hee-Jin
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Abstract
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Superior mesenteric artery syndrome is caused by compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta. Recently, we experienced a case of a gastric bezoar combined with SMA syndrome. A 58-year-old man presented with upper abdominal pain, bloating and weight loss of 5 kg. An endoscopic examination identified a huge gastric bezoar. The bezoar was broken and fragmented into small pieces using an argon plasma coagulator and endoscopic snare catheter. Hypotonic duodenography showed a longitudinal linear band that was presumed to be a vascular impression of the third portion of the duodenum and contrast-enhanced spiral CT showed a reduced distance of 8.4 mm but a normal angle of 38.5o between the arota and the SMA. A second endoscopic examination demonstrated prominent pulsations that compressed the duodenal wall at the third portion. Luminal expansion with full inflation of air was not attempted under endoscopy. (Korean J Gastrointest Endosc 2008;37:271-275)
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KEYWORD
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SMA syndrome, Bezoar, Argon plasma coagulation
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