Duodenal diaphragm associated with superior mesenteric artery syndrome

An unusual case of duodenal diaphragm in a 24 year old patient who presented with symptoms of the superior mesenteric artery syndrome is presented. The patient had rheumatoid arthritis and had been treated with salicylates, which were thought to have produced inflammation and occlusion of the aperture to the point of complete obstruction. Complete excision of the diaphragm through anterior duodenotomy and distal duodenojejunostomy provided an excellent result.