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The Korean Journal of Medicine 2009;76(6): 727-731.
토혈을 동반한 상장간막 동맥증후군 1예
문승원, 박 혁, 문장식, 명보현, 김도현, 김호동, 한 철
A case of superior mesenteric artery syndrome with hematemesis
Seung Won Moon, Hyeuk Park, Jang Sik Mun, Bo Hyun Myoung, Do Hyun Kim, Ho Dong Kim, Chul Han
ABSTRACT
Superior mesenteric artery (SMA) syndrome is a rare disorder, characterized by compression of the third segment of the duodenum by the mesenteric artery at the level of the SMA, resulting in duodenal dilatation. The most characteristic symptoms are postprandial epigastric pain, fullness, voluminous vomiting, and eructation. The diagnosis may be difficult, but can be confirmed by upper gastrointestinal (UGI) contrast studies. We report a case of SMA syndrome in a 66-year-old patient with hematemesis. Endoscopy showed deep circular ulcerations with bleeding in the distal esophagus. Computed tomography (CT) and an UGI contrast series revealed distension of the stomach and duodenum, with a cut-off in the third portion of the duodenum. We treated the patient conservatively, but the patient’s symptoms did not improve. Ultimately, the patient underwent successful gastrojejunostomy with a favorable postoperative outcome.
Keywords: Superior mesenteric artery syndrome; Hematemesis; Upper gastrointestinal tract obstruction
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