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KMID : 0359020100400020121
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Korean Journal of Gastrointestinal Endoscopy
2010 Volume.40 No. 2 p.121 ~ p.125
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The Identification of Superior Mesenteric Artery Syndrome Established by Endoscopic Ultrasound in a Patient with Severe Gastroptosis
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Kim Seung-Joon
Chung Woo-Chul
Jung Sung-Hoon
Kwak Jae-Wuk
Lee Myung-Hyun
Paik Chang-Nyol
Lee Kang-Moon
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Abstract
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Superior mesenteric artery (SMA) syndrome is caused by compression of the transverse part of the duodenum between the SMA and the aorta, where the distance between these vessels decreases with loss of mesenteric fat. It occurs most frequently in patients with rapid weight loss. Conventionally, the diagnosis is established by digital fluoroscopy and contrast-enhanced spiral computed tomography (CT). A 17-year old woman was admitted via the emergency department with postprandial fullness, nausea, and bile stained vomiting. The initial radiological examination revealed severe gastroptosis. Fluoroscopic evaluation after barium swallowing failed due to a markedly distended stomach. The diagnosis of SMA syndrome was made by endoscopic ultrasound (EUS) using a mini-probe. EUS findings were in good agreement with the CT angiogram. A conservative trial was attempted, but symptoms remained refractory. Surgery was an alternative option and we treated the patient successfully with laparoscopic duodeno-jejunostomy.
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KEYWORD
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Superior mesenteric artery syndrome, Endoscopic ultrasound
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