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Korean J Helicobacter  Up Gastrointest Res > Volume 14(4); 2014 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2014;14(4):268-272.
DOI: https://doi.org/10.7704/kjhugr.2014.14.4.268    Published online December 10, 2014.
Superior Mesenteric Artery Syndrome with Massive Gastric Dilatation
Ho Jun Lee, Seon Young Park, Ho Goon Kim, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. drpsy@naver.com
2Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.
Abstract
Superior mesenteric artery (SMA) syndrome is a rare disorder characterized by extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and aorta, resulting in intermittent obstruction, thereby resulting in proximal duodenal and stomach dilatation. Although the most characteristic symptoms are postprandial epigastric pain, fullness, voluminous vomiting, and eructation, severe symptoms including acute massive gastric dilatation to the extent of surgical abdomen was rarely reported. We report a case of SMA syndrome in a 24-year-old patient with an eating disorder. CT and an upper gastointestinal contrast series revealed massive gastric dilatation which induced vascular compressions. Endoscopy showed deep extensive ulcerations of the whole stomach with duodenal necrosis and ischemia, which prompted immediate surgical laparotomy, but no remarkable intra-abdominal peritonitis evidence was noted. We treated the patient conservatively and the patient recovered from all the symptoms.
Key Words: Superior mesenteric artery syndrome; Eating disorders; Gastric dilatation
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