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Korean J Gastrointest Endosc > Volume 40(2); 2010 > Article
Korean Journal of Gastrointestinal Endoscopy 2010;40(2): 121-125.
심한 위 처짐을 동반한 환자에서 내시경 초음파를 이용하여 진단한 상장간막 동맥 증후군
김성준ㆍ정우철ㆍ정성훈ㆍ곽재욱ㆍ이명현ㆍ백창렬ㆍ이강문
가톨릭대학교 의과대학 성빈센트병원 내과학교실
The Identification of Superior Mesenteric Artery Syndrome Established by Endoscopic Ultrasound in a Patient with Severe Gastroptosis
Sung Jun Kim, M.D., Woo Chul Chung, M.D., Sung Hoon Jung, M.D., Jae Wuk Kwak, M.D., Myung Hyun Lee, M.D., Chang Nyol Paik, M.D. and Kang-Moon Lee, M.D.
Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
Abstract
Superior mesenteric artery (SMA) syndrome is caused by compression of the transverse part of the duodenum between the SMA and the aorta, where the distance between these vessels decreases with loss of mesenteric fat. It occurs most frequently in patients with rapid weight loss. Conventionally, the diagnosis is established by digital fluoroscopy and contrast-enhanced spiral computed tomography (CT). A 17-year old woman was admitted via the emergency department with postprandial fullness, nausea, and bile stained vomiting. The initial radiological examination revealed severe gastroptosis. Fluoroscopic evaluation after barium swallowing failed due to a markedly distended stomach. The diagnosis of SMA syndrome was made by endoscopic ultrasound (EUS) using a mini-probe. EUS findings were in good agreement with the CT angiogram. A conservative trial was attempted, but symptoms remained refractory. Surgery was an alternative option and we treated the patient successfully with laparoscopic duodeno-jejunostomy. (Korean J Gastrointest Endosc 2010;40:121-125)
Key Words: Superior mesenteric artery syndrome, Endoscopic ultrasound
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