Superior mesenteric artery syndrome in conjunction with Crohn’s disease – a case report

Česká verzia

Authors: Červinková I.; Pavlovská D.; Charvátová M.; Skotáková J.
Authors place of work: Klinika dětské radiologie LF MU a FN Brno
Published in the journal: Gastroent Hepatol 2020; 74(6): 488-491
Category: Kazuistika
doi: https://doi.org/10.48095/ccgh2020488

Summary

Summary: Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by mechanical compression of the third part of the duodenum between the abdominal aorta and the superior mesenteric artery. The relationship between Crohn‘s disease and SMAS is seldom described in literature, although patients with Crohn‘s disease have many predispositions to its development. We describe the case of a 17-year- -old female patient who has been dia gnosed with Crohn‘s disease for several years and has been experiencing symptoms of abdominal discomfort and significant weight loss for five months. Magnetic resonance imaging was a key method for dia gnosing SMAS. In addition, older contrast computed tomography scans were evaluated retrospectively with regards to the aortomesenteric angle and distance, the reduction of which is a dia gnostic criterion for SMAS. Our goal is to highlight the importance of measuring these values in patients with Crohn‘s disease for early detection of the risk of SMAS.

Keywords:

superior mesenteric artery syndrome – Crohn‘s disease – magnetic resonance imaging

Zdroje

1. Mandarry MT, Zhao L, Zhang C et al. A comprehensive review of superior mesenteric artery syndrome. Eur Surg 2010; 42 (5): 229–236. doi: 10.1007/s10353-010-0561-y.

2. So CY, Chan KY, Au HY et al. Superior mesenteric artery (SMA) syndrome: an unusual cause of intestinal obstruction in palliative care. Ann Palliat Med 2016; 6 (1): 91–93. doi: 10.21037/apm.2016.07.03.

3. Válková L. Syndrom arteria mesenterica superior – syndrom Wilkie. Interní Med 2011; 13 (9): 353–354.

4. Cicero G, D’Angelo T, Bottari A et al. Superior Mesenteric Artery Syndrome in Patients with Crohn’s Disease: a Description of 2 Cases Studied with a Novel Magnetic Resonance Enterography (MRE) Procedure. Am J Case Report 2018; 19: 431–437. doi: 10.12659/ajcr.908 273.

5. Lourenço LC, Martins A, Oliveira AM et al. Wilkie Syndrome behind Crohn Disease? Superior Mesenteric Artery Syndrome Mimicking and Complicating Crohn Disease of the Upper Gastrointestinal Tract. GE Port J Gastroenterol 2017; 24 (1): 50–52. doi: 10.1159/000450 873.

6. Salam HA. Superior mesenteric artery syndrome. [online]. Available from: http: //www.radiopaedia.org/cases/superior-mesenteric-artery-syndrome-2.

7. Arthurs OJ, Mehta U, Set PA. Nutcracker and SMA syndromes: What is the normal SMA angle in children? Eur J Radiol 2012; 81 (8): e854–e861. doi: 10.1016/j.ejrad.2012.04.010.

8. Welsch T, Büchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg 2007; 24 (3): 149–156. doi: 10.1159/000102 097.