Síndrome da Artéria Mesentérica Superior: Relato de Caso

Abstract

Introduction. Superior Mesenteric Artery Syndrome (SAMS) or Wilkie's syndrome is a rare condition arising from partial or complete obstruction of the third portion of the duodenum by the superior mesenteric artery anteriorly and by the aorta and vertebral column posteriorly. Regarding pathophysiology, a decrease in the aortomesenteric angle of 6-25 degrees (normal value: 38-56 degrees) is observed, as well as a decrease in the distance between these structures up to 2-8 mm (normal value: 10-20mm). Case Report. Female, 21 years old, complains of chronic abdominal pain associated with nausea, vomiting, abdominal distension and weight loss. Contrast-enhanced X-ray shows dilation of the first and second duodenal portion. On computed tomography angiography, the aortomesenteric distance was 7 mm. She underwent a side-to-side duodenojejunoanastomosis. Discussion and Conclusions: The superior mesenteric artery syndrome is a rare entity, with a clinical presentation similar to several other pathologies of the digestive system. This syndrome should be suspected in patients with chronic abdominal pain and symptoms of upper digestive obstruction.