Double trouble: A case report of concurrent superior mesenteric artery syndrome and nutcracker syndrome in a previously healthy young adult.

Abstract

Introduction and importance: Superior Mesenteric Artery (SMA) syndrome and Nutcracker Syndrome are rare vascular compression disorders that can lead to significant gastrointestinal and renal complications. SMA syndrome occurs when the duodenum is compressed between the aorta and the SMA, resulting in symptoms such as nausea, vomiting, and abdominal pain. Nutcracker Syndrome, on the other hand, involves the compression of the left renal vein, leading to renal venous hypertension and associated symptoms. The simultaneous occurrence of these two conditions is exceedingly rare and poses diagnostic and therapeutic challenges.

Case presentation: This case report describes a 36-year-old male who presented with a four-week history of postprandial abdominal pain, nausea, vomiting, and significant weight loss. Imaging studies, including CT angiography, revealed duodenal compression by the SMA, consistent with SMA syndrome, as well as compression of the left renal vein, indicative of Nutcracker Syndrome.

Clinical discussion: The coexistence of SMA syndrome and Nutcracker Syndrome raises intriguing questions about their underlying mechanisms. Anatomical variations in vascular structures may predispose individuals to both conditions. Treatment typically involves nutritional support and, in severe cases, surgical intervention. This case highlights the importance of a multidisciplinary approach to diagnosis and management.

Conclusion: This report underscores the need for a thorough evaluation in patients presenting with symptoms of vascular compression. Early diagnosis and a collaborative treatment approach can lead to favorable outcomes.