Superior Mesenteric Artery Syndrome: A Case Report

Superior mesenteric artery (SMA) syndrome is a rare condition characterized by the narrowing of the space between the SMA and the aorta, resulting in the compression of the third portion of the duodenum. This syndrome has many names, including cast syndrome, arterio-mesenteric duodenal compression syndrome, and Wilkie syndrome. This is attributed to the loss of the intervening mesenteric fat pad, posing diagnostic and therapeutic challenges due to its nonspecific presentation. We present a case of a male in his 50s, who arrived at the emergency room with complaints of episodes of nausea, vomiting, and abdominal pain with unremarkable laboratory studies, other than being hypokalemic and an acute elevation of white blood cell count. After the patient was stabilized, a computed tomography (CT) scan revealed compression at the junction of the second and third portions of the duodenum, which was later confirmed by an esophagogastroduodenoscopy (EGD) evaluation. Initially, a jejunostomy tube (J-tube) was placed for feeding purposes.