IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Superior mesenteric artery syndrome

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Vomiting and weight loss for 5 years.

Patient Data

Age: 20 years
Gender: Female

Oral contrast was administered

ct

Mildly distended stomach. Markedly distended second portion of the duodenum, with tapering of the third portion as it passes under the superior mesenteric artery.

Fluoroscopy

Similar findings of mild gastric distention with more pronounced, moderate to severe dilation of the second portion of the duodenum, tapering as it crosses midline.

Case Discussion

Typical CT and fluoroscopic appearance of superior mesenteric artery syndrome, which occurs when there is extrinsic compression of the third portion of the duodenum due to a narrowed aortomesenteric angle. 

This patient had a long treatment course which was complicated by infection from parenteric nutrition, eventually undergoing duodenojejunostomy to relieve symptoms.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.