Related Experiment Video
Updated: Sep 15, 2026

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Superior Mesenteric Artery Syndrome With Nutcracker Phenomenon in an Ulcerative Colitis Patient: A Case Report and
Abdulla Alabed1, Mohamed Wael1, Mariam Adnan1
1Internal Medicine Department, King Hamad University Hospital, Muharraq, Kingdom of Bahrain.
Abstract:
Superior mesenteric artery syndrome (SMAS) and nutcracker phenomenon or syndrome (if with symptoms) are rare conditions. The former is caused by the compression of the third part of the duodenum between the aorta and the superior mesenteric artery (SMA), leading to duodenal obstruction, while the latter is caused by the compression of the left renal vein between the SMA and the aorta, leading to distal dilation of the vein. Coexistence of both conditions is extremely rare, and up to 2017, only 8 cases were reported. Upon literature review, a few case reports linked either SMAS or the nutcracker phenomenon with Crohn's disease. To the best of our knowledge, no ulcerative colitis case diagnosed concurrently with SMAS or nutcracker syndrome was found. We report the case of a 20-year-old woman with active ulcerative colitis who presented with a flare-up as well as weight loss, nausea, and vomiting. In addition to her active ulcerative colitis, she was found to have concurrent SMAS and the nutcracker phenomenon upon radiological investigations. SMAS and the nutcracker phenomenon are extremely rare to occur concurrently. Management of such cases can be challenging and ranges from nutritional support to surgical interventions.
Related Concept Videos
Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease I: Introduction
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Inflammatory Bowel Disease II: Ulcerative Colitis
Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory Bowel Disease IV: Clinical Manifestations
