Superior Mesenteric Artery Syndrome: An Atypical Case with a Severe Complication

Superior mesenteric artery syndrome (SMAS) is an uncommon disease involving upper gastrointestinal obstruction. It has been postulated that a decrease in the angle between the superior mesenteric artery and the aorta results in occlusion of the third portion of the duodenum, especially in patients who lose body weight rapidly. We present a case of SMAS in a well-nourished, risk-free boy who was admitted owing to abdominal pain and vomiting after eating a large meal and suffered subsequent gastric perforation several hours later. Diagnostic evaluation revealed compression over the third portion of the duodenum by the SMA.