Superior mesenteric artery syndrome in a child with brain injury. Case report

Superior mesenteric artery syndrome is a rare cause of upper intestinal obstruction in both adults and children. This report describes an 11-yr-old boy with severe traumatic brain injury who developed superior mesenteric artery syndrome while undergoing rehabilitation. After the onset of postprandial bilious vomiting, an upper gastrointestinal x-ray series revealed abrupt obstruction of flow of barium at the third part of the duodenum with dilation of the first and second portions and antiperistaltic flow of barium. He was treated nonsurgically and feeding was accomplished using a tube passed into the jejunum. No recurrence was reported at follow-up 2 yr later. Prolonged recumbency and recent weight loss were considered as the precipitating factors.