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Case Report
 
Superior mesenteric artery syndrome: A rare case of bowel obstruction in schizophrenic patient
Ing How Moo1, Michael John Clarke2, Tiong Thye Goo3, Kee Wee Lim4
1MBBS, UNSW, House Officer, General Surgery, Khoo Teck Puat Hospital, Singapore.
2MBBS, (Melbourne), FRANZCR, Consultant, Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.
3MBBS, MRCS, Surgical Registra, General Surgery, Khoo Teck Puat Hospital, SINGAPORE.
4MBBS, (S’pore), MRCS (Edin), MMed (Gen Surg), Consultant, General Surgery, Khoo Teck Puat Hospital, Singapore.

doi:10.5348/ijcri-2013-11-389-CR-3

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Ing How Moo
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How to cite this article:
Moo IH, Clarke MJ, Goo TT, Lim KW. Superior mesenteric artery syndrome: A rare case of bowel obstruction in schizophrenic patient. International Journal of Case Reports and Images 2013;4(11):597–601.


Abstract
Introduction: Superior mesenteric artery syndrome is a rare condition of obstruction to the third part of duodenum. Identification of this syndrome is challenging and is frequently made by a process of exclusion.
Case Report: We report the first case of superior mesenteric artery syndrome in a severely cachectic schizophrenic patient with paranoid delusions who presented with features of proximal gastrointestinal obstruction. The diagnosis was not straightforward and was supported by radiologic evidence of obstruction. The patient was treated conservatively with nasogastric tube decompression, fluid and electrolyte correction and enteral nutrition via nasojejunal tube. However, the patient was not cooperative with treatment and subsequently demised.
Conclusion: This report aims to strengthen the awareness of this condition to prevent delay in diagnosis and treatment of this life-threatening condition.

Keywords: Superior mesenteric artery (SMA) syndrome, Schizophrenic patient


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Author Contributions
Ing How Moo – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Michael John Clarke – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Tiong Thye Goo – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Kee Wee Lim – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Ing How Moo et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)