Rare Diagnostic Case of Superior Mesenteric Artery Syndrome: Case Report

Wilkie's syndrome, another name for superior mesenteric artery (SMA) syndrome, is an uncommon cause of proximal small intestinal blockage. It happens when the angle between the abdominal aorta and the SMA narrows, causing compression of the third section of the duodenum between them, near their origin.


Here, we describe radiological findings of such a rare case of proximal small bowel obstruction in a young female patient who presented long time of repeated chronic symptoms of recurring post-eating epigastric pain and vomiting, with no symptomatic relief on medications.


An abdominal CT scan revealed distension of the duodenum and stomach, with narrowing of the third portion of the duodenum as it was compressed between the SMA and aorta. The reduced angle between the SMA and the abdominal aorta was indicative of SMA syndrome. These findings were confirmed following a duodenojejunostomy procedure.


Accurate diagnosis and reporting of SMA syndrome are crucial, as the non-specific clinical presentation of small bowel obstruction can principally lead to delayed detection, resulting in chronic symptoms, complications, repeated hospitalizations, and electrolyte imbalances.