A 31-year-old woman presented with a 7-year history of recurrent upper abdominal pain and vomiting that exacerbated after meals, and a history of substantial weight loss. At presentation, her weight and BMI were 26 kg and 15.6 kg/m2, respectively. Routine blood tests and an abdominal ultrasonogram did not reveal any abnormality. However, endoscopy revealed mild duodenal bulb deformity, while barium studies and CT scans demonstrated narrowing of the third part of the duodenum. Consequently, after exclusion of other potential causes, the patient was diagnosed with Superior Mesenteric Artery Syndrome (SMAS), a rare condition where the duodenum becomes compressed between the aorta and superior mesenteric artery, often due to weight loss. Treatment began with naso-jejunal feeding, with plans for surgical intervention if no improvement was seen after 6 weeks. However, two weeks after starting treatment, she improved symptomatically, gained five kilograms of weight, and was able to take food without pain. So, the naso-jejunal tube was removed. This case highlights the importance of considering SMAS in patients with unexplained weight loss, abdominal pain, and vomiting, particularly in young women. Early diagnosis through careful clinical evaluation and radiological investigations is crucial for effective management.
Keywords: duodenal compression; nutritional support; superior mesenteric artery syndrome (SMAS); weight loss.
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