Superior Mesenteric Artery Syndrome: A Potentially Fatal but Reversible Gastrointestinal Manifestation of Systemic Sclerosis.
Choon-Guan ChuaGervais Khin-Lin WansaicheongWee-Chian LimBernard Yu-Hor ThongPublished in: Case reports in rheumatology (2020)
Superior mesenteric artery syndrome (SMAS) is a rare gastrointestinal disorder characterised by vascular compression of the third part of the duodenum, in the angle between the superior mesenteric artery (SMA) and the abdominal aorta. It presents as an uncommon cause of upper gastrointestinal obstruction. In patients with systemic sclerosis (SSc), gastrointestinal involvement may result in oesophageal dysmotility, gastroesophageal reflux disease (GERD), gastroparesis, small intestinal bacterial overgrowth (SIBO), chronic intestinal pseudoobstruction (CIPO), and fecal incontinence. Malnutrition may thus result in weight loss and reduced mesenteric and retroperitoneal adipose tissue, decreasing the angle between the SMA and aorta causing SMAS. Enteral or parenteral feeding can potentially reverse SMAS in SSc. We report a case of SMAS in an elderly female with SSc and concurrent gastrointestinal involvement, and discuss the important management considerations and potential adverse outcomes when untreated.
Keyphrases
- systemic sclerosis
- interstitial lung disease
- adipose tissue
- weight loss
- gastroesophageal reflux disease
- aortic valve
- high resolution
- case report
- bariatric surgery
- squamous cell carcinoma
- insulin resistance
- type diabetes
- pulmonary artery
- risk assessment
- roux en y gastric bypass
- rheumatoid arthritis
- gastric bypass
- idiopathic pulmonary fibrosis
- robot assisted
- human health
- obese patients
- aortic dissection