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Rare disease
CASE REPORT
Superior mesenteric artery syndrome in a healthy active adolescent
  1. Tsuyoshi Okamoto1,
  2. Takumi Sato2 and
  3. Yukio Sasaki3
  1. 1 Pediatric Intensive Care Unit, Nagano Children’s Hospital, Azumino, Japan
  2. 2 Department of Pediatrics, Hirosaki National Hospital, Hirosaki, Japan
  3. 3 Department of Radiology, Hirosaki National Hospital, Hirosaki, Japan
  1. Correspondence to Dr Tsuyoshi Okamoto, okamototsuyoshi{at}hotmail.com

Abstract

This report discusses a case of superior mesenteric artery (SMA) syndrome in a previously healthy 15-year-old boy with no weight loss or other common risk factors. The patient presented to the emergency department with acute bilious vomiting and epigastric pain after acute consumption of a meal and excessive quantities of water. The patient was diagnosed with SMA syndrome based on the findings of contrasted CT of the abdomen. In early puberty, boys have a significant increase in lean body mass and a concomitant loss of adipose tissues. These pubertal changes lead to a narrowing of the aortomesenteric space. The acute consumption of food and water caused a transient obstruction at the already-narrowed space, which resulted in the manifestation of SMA syndrome. This case demonstrates that pubertal growth spurt is a risk factor for SMA syndrome, and acute excessive ingestion can trigger SMA syndrome among those in puberty.

  • paediatrics
  • stomach and duodenum
  • primary care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2018-228758

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    Footnotes

    • Contributors TO is the principal author of the case report and contributed to the management of the patient. TS has been responsible for critically revising the manuscript and supervising the management of the patient by TO. YS has aided in providing the radiological interpretations.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.