[Superior mesenteric artery syndrome as a cause of chronic partial intolerance to oral feeding. Report of a case and review of the subject].
BACKGROUND
Superior mesenteric artery syndrome (SMAS) is the obstruction of the duodenum in the third portion due to this artery. We present a case of chronic oral feeding intolerance due to this problem.


METHODS
A 24 year-old woman, with a time of evolution of 1 year and a half of postprandial epigastric pain with nausea, vomiting, and loss of 30 kg managed as acid-peptic disease. The patient was studied with gastrointestinal contrast study and endoscopy without conclusive results. The patient was admitted for unstoppable vomiting, malnutrition, and severe dehydration. A laparotomy was performed and SMAS was identified. We performed Treitz's ligament section and gastrojejunoanastomosis. Her clinical outcome was satisfactory and the patient was discharged without complications.


CONCLUSIONS
SMAS is also called Wilkie's syndrome. SMAS is more frequent in women between the 10 and 39 years. The disease due to the decrease of the angle between the superior mesenteric artery and the aorta, to the anomalous origin of this artery, or to the shortening of Treitz's ligament. SMAS may appear as a sudden weight loss. Food intolerance is a predominant symptom. Diagnosis can be made with x-ray studies. Treatment is medical or surgical, with Treitz's ligament section, duodenojejunoanastomosis, and in some cases gastrojejunoanastomosis.


CONCLUSIONS
SMAS should be considered as no the differential diagnosis of chronic oral feeding intolerance.
Sánchez-Lozada
Raúl
R
Servicio de Cirugía, Hospital General de México.
Acosta-Rosero
Ana Vanessa
AV
Balas-Salame
Carlos
C
Chapa-Azuela
Oscar
O
Hurtado-López
Luis Mauricio
LM
D000328:Adult; D002908:Chronic Disease; D004066:Digestive System Diseases / Q000209:etiology*; D004435:Eating; D005260:Female; D006801:Humans; D013478:Superior Mesenteric Artery Syndrome / Q000150:complications*
Síndrome de la arteria mesentérica superior como causa de intolerancia parcial crónica a la alimentación oral. Reporte de un caso y revisión del tema.