Superior mesenteric artery syndrome leading to reversible mucosal gangrene

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Vascular Surgery

Background:

• Superior Mesenteric Artery Syndrome (SMAS) is a rare condition causing upper intestinal compression.
• Cachexia and neurological conditions like cerebral palsy can predispose patients to SMAS complications.
• Gastrointestinal distention is a known symptom of SMAS.

Purpose of the Study:

• To report an extremely rare case of SMAS leading to membranous gangrene and septic shock.
• To emphasize the importance of considering SMAS in cachectic patients with unexplained refractory shock and gastric distention.

Main Methods:

• Case report of a 60-year-old female patient.
• Clinical presentation and diagnostic findings associated with SMAS, gangrene, and septic shock.
• Review of literature for similar rare associations.

Main Results:

• The patient developed membranous gangrene and septic shock secondary to gastrointestinal distention caused by SMAS.
• The combination of SMAS and septic shock was identified as extremely rare.
• Refractory shock in cachectic patients with gastric distention was linked to potential SMAS.

Conclusions:

• SMAS can progress to life-threatening complications like gangrene and septic shock.
• Early consideration of SMAS is crucial in cachectic patients presenting with gastric distention and refractory shock of unknown origin.
• This case underscores the severe potential sequelae of SMAS, even in the absence of typical risk factors.