Acquired Superior Mesenteric Artery Syndrome: A Case Report with Associated Mortality

Authors

DOI:

https://doi.org/10.22516/25007440.1196

Keywords:

Superior Mesenteric Artery Syndrome, intestinal obstruction, weight loss, breast neoplasm, duodenal obstruction

Abstract

Introduction: Superior Mesenteric Artery Syndrome (SMAS) is a rare vascular-origin intestinal obstruction affecting the third portion of the duodenum. It is often underdiagnosed due to its multiple confounding factors, leading to delays in diagnosis and a high morbidity and mortality rate. The primary underlying mechanism is significant weight loss, and it is more commonly seen in young women. Current treatment approaches include either medical management or minimally invasive surgery.

Case Presentation: We present the case of a 61-year-old woman with a six-month history of insidious abdominal pain and recurrent episodes of vomiting, accompanied by severe weight loss. Imaging studies confirmed a diagnosis of SMAS, which was secondary to tumor recurrence in metastatic breast cancer. Conservative management was initiated; however, the patient ultimately succumbed to infectious complications.

Conclusions: SMAS is a rare and challenging condition to diagnose. Various underlying factors contribute to significant weight loss, which is central to its pathophysiology. Computed tomography (CT) and magnetic resonance imaging (MRI) are the preferred diagnostic modalities. While conservative management remains the first-line treatment, it is associated with a high recurrence rate. Surgical intervention, though an option, carries substantial morbidity risks due to the complexity of the procedure.

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Author Biographies

Jorge Carmelo Martínez-Gil, Universidad Nacional de Colombia

Resident of Internal Medicine, Universidad Nacional de Colombia. Bogotá, Colombia.

Carlos Mauricio Martínez-Montalvo, Universidad Nacional de Colombia

Internist, Universidad del Rosario. Fellow in Gastroenterology, Universidad Nacional de Colombia. Bogotá, Colombia.

Oscar Fernando Ruíz Morales, Universidad Nacional de Colombia

Internist and Gastroenterologist, Hospital Universitario Nacional de Colombia. Bogotá, Colombia.

Martín Alonso Gómez Zuleta, Universidad Nacional de Colombia

Internist and Gastroenterologist, Hospital Universitario Nacional de Colombia. Bogotá, Colombia.

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Figure 1. Contrast-enhanced abdominal CT scan in the sagittal section showing an angle of 22° between the aorta and the superior mesenteric artery. The image is the property of the authors.

Published

2025-04-12

How to Cite

Martínez Gil, J. C., Martínez Montalvo, C. M., Ruíz Morales, O. F., & Gómez Zuleta, M. A. (2025). Acquired Superior Mesenteric Artery Syndrome: A Case Report with Associated Mortality. Revista Colombiana De Gastroenterología, 40(1), 95–98. https://doi.org/10.22516/25007440.1196

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Section

Case report