Clinical Usefulness of Gastric-emptying Scintigraphy in Superior Mesenteric Artery Syndrome: A Case Report

Introduction

Superior mesenteric artery (SMA) syndrome is a rare disease caused by the compression of the third portion of the duodenum between the SMA and the abdominal aorta. The prevalence is 0.005 %−0.3 % in the general population, and barium swallow for upper gastrointestinal (UGI) examination, oesophago-gastro-duodenoscopy (OGD), and imaging studies show that women are more commonly affected than men [1] [2]. In healthy individuals, the physiologic aortomesenteric angle is sustained by the left renal vein, and the uncinated process of the pancreas embedded in retroperitoneal fat and lymph tissue prevents the compression of the duodenum [2]. In SMA syndrome, acute angulation and decreased distance between the SMA and the aorta could be caused by acute weight loss, trauma, dietary disorders, surgery, and anatomical and congenital anomalies [1] [2]. It has nonspecific upper gastrointestinal (UGI) obstruction symptoms, and delayed diagnosis may lead to life-threatening conditions such as dehydration, metabolic alkalosis, peritonitis, and gastric perforation [1]. Contrast-enhanced computed tomography (CECT) findings of an acute angulation and narrow distance between the SMA and the aorta in a patient with UGI obstruction symptoms could raise clinical suspicion of SMA syndrome and contribute to making a diagnosis [3]. Meanwhile, gastric-emptying scintigraphy (GES) is a well-known imaging modality for evaluating gastroparesis and analysing gastric motility [4]. We present a case of SMA syndrome in a 55-year-old woman who presented with dyspepsia and her GES results.

Publication History

Article published online:
30 March 2020

• References

• 1 Sinagra E, Raimondo D, Albano D. et al. Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings. Gastroenterol Res Pract 2018; 2018: 1937416
• 2 Welsch T, Büchler MW, Kienle P. Recalling Superior Mesenteric Artery Syndrome. Dig Surg 2007; 24: 149-156
• 3 Konen E, Amitai M, Apter S. et al. CT angiography of superior mesenteric artery syndrome. Am J Roentgenol 1998; 171: 1279-1281
• 4 Maurer AH. Gastrointestinal Motility, Part 1: Esophageal Transit and Gastric Emptying. J Nucl Med 2015; 56: 1229-1238
• 5 Knight LC. Update on gastrointestinal radiopharmaceuticals and dosimetry estimates. Semin Nucl Med 2012; 42: 138-144