Superior Mesenteric Artery Syndrome With Acute Abdomen: A Case Report and Review of the Japanese Literature

Abstract

We report the case of a 14-year-old girl who presented with acute abdominal pain. Ultrasound ruled out appendicitis, but the abdominal pain recurred when she had oral intake. She had a history of body weight loss over a period of three months. Contrast computed tomography and ultrasound showed the dilation of the stomach and duodenum and the narrowing of the aorto-mesenteric distance. She was diagnosed as having superior mesenteric artery (SMA) syndrome. Enteral nutrition was initiated because the upper gastrointestinal tract indicated that she was able to take liquid orally in a lordotic position. Oral intake was gradually increased, and she was discharged 12 days after admission. Classically, SMA syndrome was considered to be seen in patients with chronic underlying diseases. However, of the 56 pediatric cases of SMA syndrome previously reported in Japan, only 15 (26.8%) cases involved underlying diseases. Although SMA syndrome is an atypical cause of acute abdominal pain without any other symptoms, it is important to consider SMA syndrome for differential diagnosis.