A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon
Superior mesenteric artery (SMA) syndrome is a rare cause of gastrointestinal obstruction, caused by external compression of the third part of the duodenum by the SMA. It may be associated with the Nutcracker phenomenon: external compression of the left renal vein. To our knowledge, there are few re...
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| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2015/649469 |
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| author | Rebecca Nunn Jaimie Henry Alistair A. P. Slesser Rukshan Fernando Nebil Behar |
| author_facet | Rebecca Nunn Jaimie Henry Alistair A. P. Slesser Rukshan Fernando Nebil Behar |
| author_sort | Rebecca Nunn |
| collection | DOAJ |
| description | Superior mesenteric artery (SMA) syndrome is a rare cause of gastrointestinal obstruction, caused by external compression of the third part of the duodenum by the SMA. It may be associated with the Nutcracker phenomenon: external compression of the left renal vein. To our knowledge, there are few reports in the literature describing the coexistence of these two conditions and so we take this opportunity to highlight a rare cause of the acute abdomen that might otherwise be overlooked in cases of nonspecific abdominal findings and potentially unremarkable initial investigations. We report a case of SMA syndrome and Nutcracker phenomenon in a 19-year-old female who presented to our emergency department with a short history of epigastric pain and emesis. The SMA syndrome is thought to develop as the result of an abnormally narrow angle between the proximal SMA and the aorta, for which a number of predisposing factors have been described. Surgical options exist; however, the SMA syndrome is typically managed conservatively in the first instance, consistent with the approach described in this case. The Nutcracker phenomenon may give rise to the Nutcracker syndrome in the presence of typical clinical manifestations; however, these did not feature in this case. |
| format | Article |
| id | doaj-art-d62ee0d936b74f3bb947ea4e3d8ddcfe |
| institution | OA Journals |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
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| series | Case Reports in Surgery |
| spelling | doaj-art-d62ee0d936b74f3bb947ea4e3d8ddcfe2025-08-20T02:19:38ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/649469649469A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker PhenomenonRebecca Nunn0Jaimie Henry1Alistair A. P. Slesser2Rukshan Fernando3Nebil Behar4Department of General Surgery, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UKDepartment of General Surgery, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UKDepartment of General Surgery, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UKDepartment of Radiology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UKDepartment of General Surgery, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UKSuperior mesenteric artery (SMA) syndrome is a rare cause of gastrointestinal obstruction, caused by external compression of the third part of the duodenum by the SMA. It may be associated with the Nutcracker phenomenon: external compression of the left renal vein. To our knowledge, there are few reports in the literature describing the coexistence of these two conditions and so we take this opportunity to highlight a rare cause of the acute abdomen that might otherwise be overlooked in cases of nonspecific abdominal findings and potentially unremarkable initial investigations. We report a case of SMA syndrome and Nutcracker phenomenon in a 19-year-old female who presented to our emergency department with a short history of epigastric pain and emesis. The SMA syndrome is thought to develop as the result of an abnormally narrow angle between the proximal SMA and the aorta, for which a number of predisposing factors have been described. Surgical options exist; however, the SMA syndrome is typically managed conservatively in the first instance, consistent with the approach described in this case. The Nutcracker phenomenon may give rise to the Nutcracker syndrome in the presence of typical clinical manifestations; however, these did not feature in this case.http://dx.doi.org/10.1155/2015/649469 |
| spellingShingle | Rebecca Nunn Jaimie Henry Alistair A. P. Slesser Rukshan Fernando Nebil Behar A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon Case Reports in Surgery |
| title | A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon |
| title_full | A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon |
| title_fullStr | A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon |
| title_full_unstemmed | A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon |
| title_short | A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon |
| title_sort | model example coexisting superior mesenteric artery syndrome and the nutcracker phenomenon |
| url | http://dx.doi.org/10.1155/2015/649469 |
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