[The diagnosis of aorticomesenteric duodenal compression by magnetic resonance angiography]

The syndrome of duodenal obstruction by the mesenteric artery is an infrequent condition that nevertheless was too often diagnosed in the past. The development of modern imaging techniques has presently restricted the diagnosis of this syndrome. We report the case of a 21-year-old patient with superior mesenteric artery-induced duodenal compression syndrome secondary to malnutrition and loss of weight. Diagnosis was confirmed by the evaluation of bowel transit, CT Scan, NMR and angio-MR. Conservative treatment with total parenteral nutrition proved ineffective. Surgical sectioning of the ligament of Treitz and extensive mobilization of the duodenum (Strong's operation) was performed; outcome was unsatisfactory, however. A duodenojejunostomy was performed later, which finally solved the condition. We emphasize the diagnostic usefulness of CT Scan and angio-MR, and the favorable results afforded by duodenojejunostomy.