Superior mesenteric artery syndrome and nutcracker syndrome in a patient with pectus carinatum and spine scoliosis.

Abstract

A male patient with pectus carinatum and spine scoliosis deformity presented with a 7-day history of recurrent episodes of nausea, vomiting and abdominal distention. He reported a weight loss of about 10 kg in the last 6 months and an altered eating habit. The contrast-enhanced CT of the abdomen revealed a significant compression of the third part of the duodenum, reduced the aortomesenteric distance and left renal vein compression between the abdominal aorta and superior mesenteric artery. A diagnosis of superior mesenteric artery syndrome with nutcracker syndrome was made. The patient's symptoms persisted on conservative management, and surgical correction was planned where a side-to-side anastomosis of the second part of the duodenum and jejunum was performed. The nutcracker syndrome was managed conservatively with ongoing surveillance. The patient did well postoperatively and was discharged without any complications. Until 4 months of follow-up, his weight improved, and urine examination did not show haematuria.