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Abstract
Superior mesenteric artery (SMA) syndrome is a rare condition that must be differentiated from other gastrointestinal diseases manifesting as upper abdominal pain, nausea, or vomiting. The description of SMA syndrome is compression of the third portion of the duodenum by the SMA and the abdominal aorta. SMA syndrome is managed with nasoenteral nutrition or surgical strategies such as laparoscopic duodenojejunostomy. However, SMA syndrome treated using enteral nutrition by percutaneous radiologic gastrojejunostomy has not been reported. Here, we report our experience of successfully managing a case of SMA syndrome with percutaneous radiologic gastrojejunostomy.
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Fig. 1.
A distended and enlarged stomach dropped into the pelvic cavity. The silhouette of the stomach is noted at the level of the second sacral vertebra (arrows).
Fig. 2.
Abdominal CT. (A) Axial CT image of the abdomen demonstrates massive dilatation of the stomach and proximal duodenum. (B) Sagittal-view CT shows the compressed duodenum between the superior mesenteric artery and the abdominal aorta (white circle).
Fig. 3.
Radiograph showing combined nasogastric and nasoenteral tube placement. (A) A nasoenteral tube was inserted into the duodenum through the pylorus in the presence of a former nasogastric tube (dark arrow). (B) Contrast dye injection was performed to confirm the intrajejunal location of the tube tip (white arrow).
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