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Middle mediastinal mass secondary to aneurysm of aorticopulmonary collateral
Joseph Junewick, MD FACR
over 8 years ago
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SMA Syndrome

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT FL
Activities:
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History

Teenager with vomiting.


Case Images


Diagnosis

SMA Syndrome

Findings

FL – Linear impression of the superior mesenteric artery on the transverse duodenum. Antegrade progress of barium was impeded while the patient was supine and facilitated while prone (on hands and knees).

CT – Markedly dilated stomach and proximal duodenum with abrupt tapering of the transverse duodenum at the aortomesenteric zone.

Discussion

Superior mesenteric artery syndrome is characterized by the compression of the third segment of duodenum between the aorta and superior mesenteric artery resulting proximal bowel dilatation. In its acute or chronic form, the syndrome is clinically manifest by postprandial epigastric pain, satiety, and vomiting. Etiology may be related to weight loss (loss of fat around the SMA) and/or accelerated vertical growth narrowing the angle between the aorta and SMA.

Reference

Schlesinger AE. Duodenum: Acquired Obstruction in Caffey’s Pediatric Diagnostic Imaging, 11th Ed. Mosby Elsivier (2008).



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