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SMA Syndrome
Case Detail
| Anatomy: Gastrointestinal |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Developmental or Congenital |
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| Created: 10 months ago |
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| Updated: 9 months ago |
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| Tags:
PEDS
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| Modality/Study Types:
CT
FL
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Activities:  PDF  ImageJA |
History
Teenager with vomiting.
Case Images
Diagnosis
SMA Syndrome
Findings
FL – Linear impression of the superior mesenteric artery on the transverse duodenum. Antegrade progress of barium was impeded while the patient was supine and facilitated while prone (on hands and knees).
CT – Markedly dilated stomach and proximal duodenum with abrupt tapering of the transverse duodenum at the aortomesenteric zone.
Discussion
Superior mesenteric artery syndrome is characterized by the compression of the third segment of duodenum between the aorta and superior mesenteric artery resulting proximal bowel dilatation. In its acute or chronic form, the syndrome is clinically manifest by postprandial epigastric pain, satiety, and vomiting. Etiology may be related to weight loss (loss of fat around the SMA) and/or accelerated vertical growth narrowing the angle between the aorta and SMA.
Reference
Schlesinger AE. Duodenum: Acquired Obstruction in Caffey’s Pediatric Diagnostic Imaging, 11th Ed. Mosby Elsivier (2008).