誘因なく発症した上腸問膜動脈症候群の1例

Abstract

Superior mesenteric artery (SMA) syndrome is a relatively rare disease, which is caused by the obstruction of the third portion of the duodenum due to extrinsic compression by the SMA and the abdominal aorta. Although anatomical characteristics, such as the acute angle of the SMA to the abdominal aorta and proximity of the SMA to the abdominal aorta, are considered as underlying factors for causing SMA syndrome, most cases occur with predisposing factors such as rapid body weight loss and rapid growth. We recently experienced a case of SMA syndrome that had occurred without any considerable predisposing factors. The patient was a 17-year-old female, who had neither lost weight nor experienced recent increase in height. ' She was also stable psychosomatically and had not been taking a slimming diet. She suddenly started vomiting shortly after meals and lost 4 kg in weight over 10 days. Although gastrointestinal fiberscopy did not show significant findings, upper gastrointestinal X-ray series revealed a sharp cut-off and obstruction to the passage of barium in the third portion of the duodenum. This obstruction was restored in a prone position. Subsequent magnetic resonance images did not show any tumorous lesions in the abdomen, resulting in the diagnosis of SMA syndrome. She recovered from the symptom by taking a prone position after meals. SMA syndrome caused without predispos- ing factors is considered to be a rare case and the related literature is reviewed.