Description

A 28-year-old man (body mass index (BMI) of 15.6 kg/m²) with untreated HIV infection since 2004 was admitted to the hospital with a 3-month headache, generalised weakness and neurocognitive deficit. He underwent head MRI and a ring-enhancing lesion was found in subcortical temporal-occipital location. Cerebral biopsy revealed primary central nervous system lymphoma. The patient received chemotherapy with cytarabine, rituximab and high-dose methotrexate without complications. Simultaneously, he was started on antiretroviral therapy (ritonavir, darunavir, raltegravir and tenofovir). Two weeks after highly active antiretroviral therapy (HAART) onset, he developed sudden abdominal pain, distention and profuse biliary vomit. CT angiography revealed severe dilation of the stomach and duodenum until its third portion with a transition zone at the level of the superior mesenteric artery (SMA) (figure 1).

An aortomesenteric angle of …