Superior Mesenteric Artery Syndrome Caused by Abdominal Aortic Aneurysm and Mesenteric Adhesion

Abstract

An 81-year-old man with a complaint of abdominal pain and vomiting was admitted to our hospital. Computed tomography revealed that the third portion of the duodenum was obstructed between the superior mesenteric artery (SMA) and the abdominal aorta. Just below the obstruction site, a 60-mm abdominal aortic aneurysm (AAA) was observed. The patient was diagnosed as having SMA syndrome (SMAS) due to AAA. We performed abdominal aorta artificial blood vessel replacement. As the patient had a history of cholecystectomy, the mesentery was adhered strongly and the mobility of the SMA was limited. Soon after repair of the AAA and adhesion, the symptoms of SMAS improved, and the postoperative course was good. SMAS caused by AAA is rare, and this is the first reported case of SMAS due to not only AAA but also mesenteric adhesion.