Duodenal Emphysema Complicated with Superior Mesenteric Artery Syndrome in a Patient with Cerebral Paralysis: A Case Report.

Superior mesenteric artery syndrome (SMAS) is characterized by an arteriomesenteric duodenal compression commonly resulting from significant weight loss. Vomiting is the most frequent symptom. SMAS can be complicated by massive gastric dilatation. Patients with cerebral palsy have various factors that can predispose them to SMAS. In this paper, we report a rare case of SMAS complicated by duodenal, peritoneal and retroperitoneal emphysema in a patient with cerebral paralysis, referring to the relevant literature. In this case, severe vomiting associated with epilepsy and weight loss may have contributed to the development of duodenal emphysema.

[1]  R. Tubbs,et al.  Superior mesenteric artery syndrome and its associated gastrointestinal implications , 2014, Clinical anatomy.

[2]  W. Nealon,et al.  Superior Mesenteric Artery Syndrome Presenting with Pneumoperitoneum and Pneumomediastinum , 2013, The American surgeon.

[3]  Y. Janjigian,et al.  Distinguishing benign and life-threatening pneumatosis intestinalis in patients with cancer by CT imaging features. , 2013, AJR. American journal of roentgenology.

[4]  Taeyun Kim,et al.  [A case of gastric emphysema in anorexia nervosa presenting as acute gastric distension]. , 2012, The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi.

[5]  S. Sarnacki,et al.  Portal venous gas and thrombosis complicating superior mesenteric artery syndrome (Wilkie's syndrome) in a child. , 2010, Journal of pediatric surgery.

[6]  Y. Auh,et al.  Extension of air into the right perirenal space after duodenal perforation: CT findings. , 2009, Radiology.

[7]  Yasuhiro Yamamoto,et al.  Gastric pneumatosis and portal venous gas in superior mesenteric artery syndrome. , 2006, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology.

[8]  S. Werlin,et al.  Superior Mesenteric Artery Syndrome in Children: A 20-Year Experience , 2006, Journal of pediatric gastroenterology and nutrition.

[9]  Soumitra R. Eachempati,et al.  Superior mesenteric artery syndrome presenting with acute massive gastric dilatation, gastric wall pneumatosis, and portal venous gas. , 2003, Surgery.

[10]  W. Mayo-Smith,et al.  Outcome of 17 patients with portal venous gas detected by CT. , 1997, AJR. American journal of roentgenology.

[11]  P. Lukeš,et al.  Diagnosis and treatment of superior mesenteric artery syndrome , 1984, The British journal of surgery.