Superior mesenteric artery syndrome: CT findings

A 45-year-old woman presented to the emergency department, with epigastric pain and multiple episodes of vomiting. History revealed significant weight loss, and similar episodes of epigastric pain and vomiting in the past, which had been self-limiting. On examination, the patient had epigastric fullness and tenderness. Contrast-enhanced CT of the abdomen revealed a grossly dilated stomach and duodenum, with an abrupt narrowing at the third part of the duodenum, with the superior mesenteric artery crossing anterior to the transition point (figures 1 and 2). The aortomesenteric angle (AMA) and aortomesenteric distance (AMD) were 14° and 2.3 mm, respectively, and were reduced (figure 3). Based on the clinical and imaging findings, a diagnosis of superior mesenteric artery (SMA) syndrome was made. The patient was treated conservatively. Figure 1 Axial contrast-enhanced CT of the abdomen shows a grossly dilated stomach and proximal duodenum with an abrupt transition point (red arrow). The SMA is seen crossing anterior to the transition …