Volume 49, Issue 4 (3-2026)
Research in Medicine 2026, 49(4): 60-67 |
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Seyed Sharifi S H, Rahimi G, Nikdel R. Superior Mesenteric Artery Syndrome Associated with Massive Gastric Dilatation and Its Proposed Surgical Management: A Case Report. Research in Medicine 2026; 49 (4) :60-67
URL: http://pejouhesh.sbmu.ac.ir/article-1-3443-en.html
URL: http://pejouhesh.sbmu.ac.ir/article-1-3443-en.html
Department of General Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran. , rasool.nikdel@gmail.com
Abstract: (919 Views)
Background and Aim: Superior mesenteric artery syndrome (SMAS) is characterized by compression of the third portion of the duodenum between the superior mesenteric artery (SMA) and the abdominal aorta as a result of the loss of retroperitoneal fat. The true incidence of this rare condition is unknown. Acute gastric dilatation secondary to SMAS may be accompanied by duodenal ischemia, intestinal pneumatosis, or portal venous gas and can be
life- threatening. This report describes a patient with SMAS complicated by severe gastric dilatation and outlines a definitive surgical approach.
Case Presentation: A 19-year-old male presented with unintended weight loss and clinical evidence of upper gastrointestinal obstruction. Imaging studies confirmed marked gastric dilatation secondary to SMAS. The patient underwent surgical duodenal decompression (duodenostomy) combined with interposition of an omental flap between the SMA and the duodenum, followed by placement of a nasogastric tube for postoperative drainage.
Conclusion: At the two-month follow-up, the patient showed a favorable outcome. Acute gastric obstruction secondary to SMAS was effectively managed by interposing an omental flap between the SMA and the duodenum to relieve vascular compression, together with duodenal decompression and nasogastric drainage. This technique offers a durable solution and may prevent recurrence of gastric dilatation and associated ischemic complications
life- threatening. This report describes a patient with SMAS complicated by severe gastric dilatation and outlines a definitive surgical approach.
Case Presentation: A 19-year-old male presented with unintended weight loss and clinical evidence of upper gastrointestinal obstruction. Imaging studies confirmed marked gastric dilatation secondary to SMAS. The patient underwent surgical duodenal decompression (duodenostomy) combined with interposition of an omental flap between the SMA and the duodenum, followed by placement of a nasogastric tube for postoperative drainage.
Conclusion: At the two-month follow-up, the patient showed a favorable outcome. Acute gastric obstruction secondary to SMAS was effectively managed by interposing an omental flap between the SMA and the duodenum to relieve vascular compression, together with duodenal decompression and nasogastric drainage. This technique offers a durable solution and may prevent recurrence of gastric dilatation and associated ischemic complications
Type of Study: Case report |
Subject:
Surgery
Received: 2024/12/30 | Accepted: 2026/02/15 | Published: 2026/06/2
Received: 2024/12/30 | Accepted: 2026/02/15 | Published: 2026/06/2
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