Abstract

Superior mesenteric artery (SMA) syndrome is a rare cause of proximal bowel obstruction due to duodenal compression by the SMA. The morbidity and mortality associated with delayed diagnosis and its complications make it an important differential cause for bowel obstruction. We report a case of mega-stomach secondary to SMA syndrome requiring total gastrectomy. An 18-year-old male presented with vomiting, abdominal pain and shock after a buffet. Computed tomography (CT) imaging revealed a grossly distended stomach (113 × 187 × 350mm) and a transition point at the third part of the duodenum, along with pneumatosis and portal venous gas. Emergency gastroscopy showed blood and necrotic mucosa. Laparotomy confirmed full thickness necrosis and the patient underwent a total gastrectomy with Roux-en-Y reconstruction. Postoperatively, he had a brief intensive care stay and recovered without complications. This case underscores the importance of considering SMA syndrome during presentations of acute gastric dilatation.

Details

Title
Necrotic mega-stomach from superior mesenteric artery syndrome
Author
Tse, Andrew 1   VIAFID ORCID Logo  ; Phan, Natalie 2 ; Ayoubi, Salah 1 ; Fenton-Lee, Douglas 1 

1  Department of Surgery, St Vincent’s Hospital Sydney , 390 Victoria St, Darlinghurst, Sydney, New South Wales, 2010 , Australia 
2  Faculty of Medicine , Nursing and Health Sciences, Monash University , Wellington Rd, Clayton, Melbourne, Victoria, 3800 , Australia 
Publication year
2024
Publication date
Jul 2024
Publisher
Oxford University Press
e-ISSN
20428812
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/jscr/rjae463
ProQuest document ID
3170763953
Copyright
Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.