Complex Gastrointestinal Case of SMA Syndrome with Vomiting and Weight Loss: A Clinical Report

Introduction Superior Mesenteric Artery (SMA) syndrome is a rare condition characterized by the compression of the third part of the duodenum by the aorta and superior mesenteric artery, leading to symptoms such as postprandial abdominal pain, nausea, vomiting, and weight loss. Young adult females are most commonly affected, with a median age of 23 years. The incidence of SMA syndrome ranges from 0.013% to 0.78%, based on radiographic studies.

Case Description/Methods A 32-year-old female with a history of SMA syndrome, substance dependencies, and depression presented with severe generalized abdominal pain, nausea, and vomiting, which had recurred over the past four to five months. Laboratory tests indicated abnormal bicarbonate, glucose, AST, lactate, and phosphorus levels. A gastroenterology consultation revealed that her significant weight loss due to the medication Mounjaro might have exacerbated her condition. CT angiography confirmed a decreased aortomesenteric angle consistent with SMA syndrome.

Discussion SMA syndrome can lead to serious complications, including bowel obstructions and significant weight loss. Diagnosis typically involves imaging, with an Upper Gastrointestinal Contrast Study being the gold standard. Key diagnostic criteria include duodenal dilation and compression, delayed contrast passage, and the Hayes maneuver for relief.

Publication History

Article published online:
27 March 2025