Clinical insights into Wilkie's syndrome: A case report and review of relevant literature
Wilkie’s syndrome, cast syndrome, or superior mesenteric artery syndrome, is a rare cause of upper intestinal obstruction due to compression of the third portion of the duodenum between the superior mesenteric artery and the abdominal aorta. It is frequently associated with significant weight loss,...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043325003930 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849725412241833984 |
|---|---|
| author | Elias Ledezma Flores Adolfo Calderón Fernández Arturo Urias Pompa Liza María Pompa González, MD, PhD |
| author_facet | Elias Ledezma Flores Adolfo Calderón Fernández Arturo Urias Pompa Liza María Pompa González, MD, PhD |
| author_sort | Elias Ledezma Flores |
| collection | DOAJ |
| description | Wilkie’s syndrome, cast syndrome, or superior mesenteric artery syndrome, is a rare cause of upper intestinal obstruction due to compression of the third portion of the duodenum between the superior mesenteric artery and the abdominal aorta. It is frequently associated with significant weight loss, causing depletion of retroperitoneal fat, and narrowing of the aortomesenteric angle and distance. We report the case of a 45-year-old male with type 2 diabetes mellitus who developed progressive gastrointestinal symptoms over four months, including early satiety, postprandial abdominal pain, vomiting of gastric and biliary contents , and severe weight loss. On evaluation, body mass index was 15 kg/m². The patient appeared cachectic, with a distended abdomen, decreased bowel sounds, and tenderness in the epigastric region. Contrast-enhanced computed tomography revealed marked gastric dilation and duodenal distension, an aortomesenteric distance of 4.71 mm, and an aortomesenteric angle of 10.95°, confirming the diagnosis. Conservative management included electrolyte correction, nasogastric decompression, intravenous fluids, a hypercaloric diet, and postural changes. This case underscores the need for clinical suspicion and prompt imaging studies to avoid complications. |
| format | Article |
| id | doaj-art-7a9a36b323c54cbaafee1700a57468a6 |
| institution | DOAJ |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-7a9a36b323c54cbaafee1700a57468a62025-08-20T03:10:28ZengElsevierRadiology Case Reports1930-04332025-08-012083964396910.1016/j.radcr.2025.04.096Clinical insights into Wilkie's syndrome: A case report and review of relevant literatureElias Ledezma Flores0Adolfo Calderón Fernández1Arturo Urias Pompa2Liza María Pompa González, MD, PhD3Faculty of Medicine, Universidad Xochicalco, Tijuana, Baja California, MexicoFaculty of Medicine and Psychology, Universidad Autónoma de Baja California, Tijuana, Baja California, MexicoFaculty of Medicine and Psychology, Universidad Autónoma de Baja California, Tijuana, Baja California, MexicoMinimally Invasive Surgery, LIMARP International Center of Excellence, Tijuana, Baja California, Mexico; Corresponding author.Wilkie’s syndrome, cast syndrome, or superior mesenteric artery syndrome, is a rare cause of upper intestinal obstruction due to compression of the third portion of the duodenum between the superior mesenteric artery and the abdominal aorta. It is frequently associated with significant weight loss, causing depletion of retroperitoneal fat, and narrowing of the aortomesenteric angle and distance. We report the case of a 45-year-old male with type 2 diabetes mellitus who developed progressive gastrointestinal symptoms over four months, including early satiety, postprandial abdominal pain, vomiting of gastric and biliary contents , and severe weight loss. On evaluation, body mass index was 15 kg/m². The patient appeared cachectic, with a distended abdomen, decreased bowel sounds, and tenderness in the epigastric region. Contrast-enhanced computed tomography revealed marked gastric dilation and duodenal distension, an aortomesenteric distance of 4.71 mm, and an aortomesenteric angle of 10.95°, confirming the diagnosis. Conservative management included electrolyte correction, nasogastric decompression, intravenous fluids, a hypercaloric diet, and postural changes. This case underscores the need for clinical suspicion and prompt imaging studies to avoid complications.http://www.sciencedirect.com/science/article/pii/S1930043325003930Superior mesenteric artery syndromeDuodenal obstructionComputed tomographyType 2 diabetes mellitusSuperior mesenteric arteryAortomesenteric angle |
| spellingShingle | Elias Ledezma Flores Adolfo Calderón Fernández Arturo Urias Pompa Liza María Pompa González, MD, PhD Clinical insights into Wilkie's syndrome: A case report and review of relevant literature Radiology Case Reports Superior mesenteric artery syndrome Duodenal obstruction Computed tomography Type 2 diabetes mellitus Superior mesenteric artery Aortomesenteric angle |
| title | Clinical insights into Wilkie's syndrome: A case report and review of relevant literature |
| title_full | Clinical insights into Wilkie's syndrome: A case report and review of relevant literature |
| title_fullStr | Clinical insights into Wilkie's syndrome: A case report and review of relevant literature |
| title_full_unstemmed | Clinical insights into Wilkie's syndrome: A case report and review of relevant literature |
| title_short | Clinical insights into Wilkie's syndrome: A case report and review of relevant literature |
| title_sort | clinical insights into wilkie s syndrome a case report and review of relevant literature |
| topic | Superior mesenteric artery syndrome Duodenal obstruction Computed tomography Type 2 diabetes mellitus Superior mesenteric artery Aortomesenteric angle |
| url | http://www.sciencedirect.com/science/article/pii/S1930043325003930 |
| work_keys_str_mv | AT eliasledezmaflores clinicalinsightsintowilkiessyndromeacasereportandreviewofrelevantliterature AT adolfocalderonfernandez clinicalinsightsintowilkiessyndromeacasereportandreviewofrelevantliterature AT arturouriaspompa clinicalinsightsintowilkiessyndromeacasereportandreviewofrelevantliterature AT lizamariapompagonzalezmdphd clinicalinsightsintowilkiessyndromeacasereportandreviewofrelevantliterature |