A Case of Superior Mesenteric Artery Syndrome during Hospitalization Due to Huge Abdominal Aortic Aneurysm

Abstract

Although cases of superior mesenteric artery syndrome (SMAS) due to abdominal aortic aneurysm (AAA) are reported, most cases being triggered by gastrointestinal symptoms. In this report, we experienced a case of SMAS that developed during hospitalization due to large AAA. The patient was a 74-year-old man. He was seen in a referring hospital with a chief complaint of lower back pain and was diagnosed with AAA with a maximum aneurysm size of 104 mm, then referred to us. We decided to undergo semi emergency surgery and started hospitalization, but he vomited on the day after admission and was diagnosed with SMAS by contrast-enhanced computed tomography (CT) . After gastric tube placement, the gastrointestinal symptoms improved. He underwent open graft replacement on hospital day 5 and was discharged home on 13 postoperative days. Considering the CT examination before and after the onset of SMAS in this case, it was thought that SMAS could be predicted from before onset during follow up of AAA.