A Case of Superior Mesenteric Artery Syndrome with An Acute Duodenal Ulcer Perforation

Abstract

The presence of any association between superior mesenteric artery syndrome (SMAS) and peptic ulcers are relatively rare. We experienced a case of superior mesenteric artery syndrome in a patient with acute perforation of the duodenal ulcer. A 25-year-old man, who had previously undergone an operation for an endoceliac abscess, was admitted to the hospital because of abdominal pain and nausea. Tenderness persisted in the epigastrium. He was diagnosed as having SMAS by an upper gastrointestinal X-ray examination and a computed tomography (CT) examination. The symptoms improved after conservative treatment. An upper endoscopic examination revealed no abnormality. However, twelve days after hospitalization, he experienced stronger abdominal pain and recrudescence of SMAS was suspected by a CT examination. Thirteen days after the hospitalization, he suddenly experienced severe abdominal pain. A CT examination and an upper endoscopic examination were done. He was diagnosed as having a perforated duodenal ulcer with peritonitis and underwent an omental patch repair. During conservative treatment for SMAS, caution should be paid to the possibility of the presence of acute peptic ulcers and their perforation.