DOI: N/A
Salam MU, Fahima K, Saha M, Salam W, Ema US, Chowdhury T
Background: Superior mesenteric artery syndrome (SMAS), also known as Wilkie’s syndrome, is an uncommon cause of proximal intestinal obstruction caused by compression of the third portion of the duodenum between the superior mesenteric artery and the aorta, most often following significant weight loss.
Case Presentation: Authors describe two young patients with superior mesenteric artery syndrome (SMAS) precipitated by weight loss. The first was a 23-year-old woman who presented with four months of postprandial epigastric pain, early satiety, bilious vomiting, and an unintentional weight loss of 8 kg, with her body mass index (BMI) decreasing from 21 to 18 kg/m². Upper gastrointestinal endoscopy suggested extrinsic duodenal compression without intrinsic pathology.
The second case involved a 22-year-old man with a one-year history of left lower abdominal pain, recurrent vomiting, and increased bowel frequency following intentional weight loss. Endoscopy revealed only erosive gastritis. Laboratory investigations were unremarkable in both cases.
Computed tomography of the abdomen revealed a reduced aortomesenteric angle in both patients, confirming the diagnosis of SMAS. Both were managed conservatively with nutritional rehabilitation and postural therapy.
Conclusion: These cases highlight weight loss as a key precipitating factor for SMAS and underscore the importance of considering this diagnosis in young patients with unexplained gastrointestinal symptoms. Early imaging facilitates timely conservative management and favorable outcomes.