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Updated: Jun 20, 2025
05:07
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
573
Necrotic mega-stomach from superior mesenteric artery syndrome
Andrew Tse1,2, Natalie Phan3, Salah Ayoubi1
1Department of Surgery, St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, Sydney, New South Wales, 2010, Australia.
Journal of Surgical Case Reports
|July 22, 2024
Summary
Superior mesenteric artery (SMA) syndrome can cause severe gastric dilatation and obstruction. This case highlights a rare instance requiring total gastrectomy due to a mega-stomach secondary to SMA syndrome.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Superior mesenteric artery (SMA) syndrome is a rare condition causing duodenal obstruction.
- Prompt diagnosis is crucial to prevent severe complications and mortality.
Observation:
- An 18-year-old male presented with acute gastric dilatation, abdominal pain, and shock after a meal.
- CT imaging revealed a massively distended stomach and duodenal compression, with signs of ischemia.
Findings:
- Emergency gastroscopy showed necrotic mucosa, necessitating exploratory laparotomy.
- Full-thickness necrosis was confirmed, leading to a total gastrectomy with Roux-en-Y reconstruction.
Implications:
- This case emphasizes SMA syndrome as a critical differential diagnosis for acute gastric dilatation.
- Early recognition and intervention are vital for managing SMA syndrome and preventing extensive gastric necrosis.
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