title: Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review).
abstract: BACKGROUND
  Superior mesenteric artery (SMA) syndrome or what is called Wiklie's syndrome is one of the rare causes of small bowel obstruction. Its exact incidence is not known. It is due to decrease in Aortomesenteric angle.
  
  
  METHODS
  A thirty-Four-year old male patient presented to our accident and emergency (department) with 3days history of epigastric pain, which was not radiating anywhere. It had no aggravating or relieving factors. Patient complained of repeated attack of vomiting as well. Contrast enhanced Computed tomography (CT) showed duodenal obstruction caused by superior mesenteric artery compression on 3rd part of duodenum.
  
  
  CONCLUSIONS
  Superior mesenteric artery syndrome (SMA) is one of the rare causes of small bowel obstruction. Incidence of superior mesenteric artery syndrome reported in literature is ranging from 0.1 to 0.3%. The most common cause is significant weight loss which leads to loss of retroperitoneal fat. Treatment usually is conservative but surgical intervention should be considered if that failed.
  
  
  CONCLUSIONS
  Superior mesenteric artery syndrome is a rare cause of intestinal obstruction but should be kept in mind. Persistent vomiting after history of weight loss should raise the suspicion of this diagnosis. Upper GI endoscopy may be necessary to exclude mechanical causes of duodenal obstruction. Contrast enhanced CT scan is useful in the diagnosis of superior mesenteric artery syndrome and can provide diagnostic information.
authors.affiliation: General Surgery Department, Rashid Hosiptal, Dubai, United Arab Emirates. Electronic address: dr_alisalem@hotmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Salem
authors.affiliation: General Surgery Department, Rashid Hosiptal, Dubai, United Arab Emirates. Electronic address: LSAlOzaibi@dha.gov.ae.
authors.forename: Labib
authors.initials: L
authors.lastname: Al Ozaibi
authors.affiliation: General Surgery Department, Rashid Hosiptal, Dubai, United Arab Emirates. Electronic address: SMNassif@dha.gov.ae.
authors.forename: Suad Mohamed Maher
authors.initials: SMM
authors.lastname: Nassif
authors.affiliation: General Surgery Department, Rashid Hosiptal, Dubai, United Arab Emirates. Electronic address: RAGOsman@dha.gov.ae.
authors.forename: Rufaida Abdel Gadir Satti
authors.initials: RAGS
authors.lastname: Osman
authors.affiliation: General Surgery Department, Rashid Hosiptal, Dubai, United Arab Emirates. Electronic address: NMAbed@dha.gov.ae.
authors.forename: Nisreen Mohammed
authors.initials: NM
authors.lastname: Al Abed
authors.affiliation: General Surgery Department, Rashid Hosiptal, Dubai, United Arab Emirates. Electronic address: fmBadri@dha.gov.ae.
authors.forename: Faisal Mohmmed
authors.initials: FM
authors.lastname: Badri
keywords: Aortomesenteric angle; Duodenal obstruction; Superior mesenteric artery (SMA) syndrome