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Concurrent Superior Mesenteric Artery and Nutcracker Syndromes: A Case Report.
Ayoub Khaled1, Ismail Chaouche1, Nizar El Bouardi1
1Department of Adult Radiology, Centre Hospitalier Universitaire (CHU) Hassan II, Sidi Mohamed Ben Abdellah University, Fez, MAR.
This case report details a rare instance of simultaneous Superior Mesenteric Artery Syndrome (SMAS) and Nutcracker Syndrome (NCS) in a teenage male. Surgical intervention for SMAS resolved symptoms, while NCS was managed conservatively.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Radiology
Background:
- Superior Mesenteric Artery Syndrome (SMAS) and Nutcracker Syndrome (NCS) are rare vascular compression disorders.
- Both conditions share a common pathophysiology but rarely occur together.
Observation:
- A 16-year-old male presented with epigastric pain, nausea, and vomiting, indicative of SMAS.
- Contrast-enhanced CT confirmed SMAS with a narrow aortomesenteric angle and NCS with left renal vein compression.
Findings:
- The patient underwent successful transmesocolic gastrojejunostomy for severe duodenal obstruction due to SMAS.
- Asymptomatic NCS was managed conservatively with surveillance.
Implications:
- This case underscores the importance of thorough imaging for diagnosing co-occurring vascular compression syndromes.
- Individualized treatment is crucial, balancing surgical intervention for symptomatic conditions with conservative management for asymptomatic ones.
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