An uncommon cause of abdominal pain and weight loss: The superior mesenteric artery syndrome

摘要

Physical examination revealed an elderly, cachectic patient. His blood pressure was 90/60 mm Hg, heart rate was 110 beats/minute, and respiratory rate 24/minute. Abdominal examination revealed a distended abdomen, mild epigastric tenderness, and hyperactive bowel sounds but there was no palpable mass or or-ganomegaly. Except mild anemia (Hgb: 11.0 g/dL) and hypokalemia (3.2 mEq/L) routine laboratory tests and urine examination were normal. Upper gastrointestinal barium study showed dilated stomach, dilated second part of the duodenum and cut off sign at the third part of duodenum with no intrinsic mucosal abnormalities. Endoscopic examination of the upper gastrointestinal tract revealed narrowing of the third part of the duodenum due to extrinsic compression. Gastroduodenoscopic examination ruled out gastric or duodenal pathology.