Superior Mesenteric Artery Syndrome: A Rare Cause of Duodenal Obstruction (Case Report)

Superior mesenteric artery (SMA) syndrome or what is called Wiklie’s syndrome is one of the rare etiologies of duodenal obstruction. It is due to decrease in Aortomesenteric angle and Its incidence is its incidence remains unknown. We report a case of a twenty-seven-year old male patient presented to our “Visceral Surgical Emergency Department, UHC ibn Rochd, Casablanca, Morocco” with with an epigastric pain evolving for 2 days, associated with bilious vomiting. The diagnosis of Wiklie’s syndrom was established by abdominal CT-scan. Transmesocolic Gastrojejunostomy was performed by laparotomy. After seven months follow-up, this patient was asymptomatic.

Superior mesenteric artery syndrome is a rare cause of duodenal obstruction that we must always think about. Persistent vomiting after history of weight loss should raise the suspicion of this diagnosis. Upper gastro intestinal endoscopy can exclude mechanical causes of duodenal obstruction. Contrast enhanced CT scan is can confirm the diagnosis of Wiklie’s syndrome.