Superior mesenteric artery syndrome, an uncommon cause of gastric outlet obstruction: Case report

Document Type

Artefact

Department

Internal Medicine (East Africa)

Abstract

Introduction and importance

Superior Mesenteric Artery (SMA) syndrome is an uncommon cause of gastric outlet obstruction secondary to duodenal compression between the SMA and the abdominal aorta. Diagnosis is challenging due to its nonspecific symptoms. We present a case highlighting an atypical presentation in a patient with normal BMI, prolonged diagnostic delay, and surgical management in a resource-limited setting.

Case presentation

We report a case of an 18-year-old female who presented with chronic abdominal pain, nausea, vomiting, and early satiety over three years. Despite a normal BMI (23.8 kg/m2), contrast-enhanced CT showed a reduced aortomesenteric angle (17°) and distance (4.5 mm), confirming SMA syndrome. Conservative management failed, necessitating duodenojejunostomy, which led to complete symptom resolution.

Clinical discussion

SMA syndrome is an uncommon and challenging diagnosis, especially in patients without classical presentations such as low BMI. Delayed diagnosis contributed to prolonged morbidity. The successful surgical intervention in a resource-limited setting emphasizes the need for increased awareness of SMA syndrome as a differential for chronic upper GI symptoms.

Conclusion

This case outlines the diagnostic challenges SMA syndrome poses due to its nonspecific nature of the clinical presentation. Improved clinical suspicion can reduce diagnostic delays and optimize management, particularly in regions with limited diagnostic resources.

Publication (Name of Journal)

International Journal of Surgery Case Reports

DOI

https://doi.org/10.1016/j.ijscr.2025.111692

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