Unraveling the Silent Crisis: A Rare Case of Acute Intestinal Obstruction Caused by Superior Mesenteric Artery Syndrome

Abstract

Superior Mesenteric Artery (SMA) Syndrome, also known as Wilkie's Syndrome, is a rare and potentially life-threatening gastrovascular disorder characterized by the compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery. This case report presents a 22-year-old male with acute intestinal obstruction secondary to SMA syndrome. The patient, who had kyphoscoliosis and syndromic features, presented with sudden-onset epigastric pain, abdominal distension, and constipation. Imaging studies, including ultrasonography and contrast-enhanced CT, confirmed SMA syndrome with associated Nutcracker syndrome. Given the severity of obstruction, the patient underwent emergency exploratory laparotomy with surgical bypass procedure. Postoperatively, patient recovered well with no complications and was discharged This case highlights the importance of early recognition and prompt surgical intervention in SMA syndrome, particularly in patients with anatomical predispositions. Delayed diagnosis can lead to severe complications such as malnutrition, electrolyte imbalance, and gastrointestinal perforation. A multidisciplinary approach is crucial for optimal patient management and long-term outcomes. The case presents the diagnostic challenge and requirement of early diagnosis and emergency surgical intervention to avoid severe complications such as malnutrition, electrolyte imbalance, or gastrointestinal perforation. With this uncommon clinical presentation and successful surgery, the study offers valuable pointers that will assist clinicians to handle such complex cases. Furthermore, it contributes to the limited literature on SMA syndrome, particularly its correlation with other congenital deformities, thereby providing more clinical knowledge and choice.