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    Prof. of Hepatology & Gastroenterology, Cairo University.

    Consultant of Hepatology,Gastroenterology and Endoscopy

    Management Positions: •

    Chief of Hepatology unit El Manial University Hospital (1994-1998).

    • Chief of Gastroentero ICU in Cairo university hospital (1997-2000)

    • President of the board of AlfaScope GI Specialized center (2004-2014).

    • Head of Endoscopy Unit in Cairo University Hospitals (2005-2010).       

     

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    استاذ الكبد و الجهاز الهضمى بكلية الطب جامعة القاهرة

    استشارى الكبد و الجهاز الهضمى و المناظير

    دكتوراه امراض الكبد و الجهاز الهضمى من كلية الطب جامعة القاهرة

    الرئيس السابق لقسم الامراض الباطنية بكلية الطب جامعة ٦ اكتوبر

    الرئيس السابق لوحدة مناظير الجهاز الهضمى و مركز الكبد و الرعاية المركزة بقصر العينى

     

    إقرأ المزيد

     

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Tuesday, Jan 22nd

Last update01:52:33 AM

        

A Case of superior mesenteric artery syndrome

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A 19 year old Yemeny female came to my clinic complaining of vomiting, heart burn and regurgitation of food, together with diffuse abdominal pain, distention, and constipation. The condition started one year ago, and was thought to be related to a psychic trauma, that happened at that time. Since then the condition was progressive and was associated with loss of weight. Upper endoscopy was performed in Yemen, after failure of repeated medical treatments, (including PPIs, prokinetics, antispasmodics, laxatives, and anti-depressants) to improve the symptoms. The endoscopy revealed incompetent cardia and pan-gastitis. The dose of PPIs was increased with no improvement. The patient came to Egypt  seeking medical advice and the following investigations were done

for her in a University hospital:

CBC, ESR, CRP: normal

Creatinine, Na, K: normal

Cortisol, thyroid hormones: normal

PP sugar, HbA1c: normal

Serum amylase & lipase: normal.

CEA, CA19-9: normal

CXR: normal

Abdominal ultrasound: normal.

Barium meal: GERD

MRI abdomen: distended stomach.

MRI pelvis: normal.

When I examined the patient, I found that she is markedly under-weight (30 kg, while her height is about 160 cm), her pulse is 90/m and regular and her BP was 90/65. Abdominal examination revealed marked distension of the upper abdomen, with tympanitic hyper-resonance, but no succution splash.

I asked for immediate plain X-ray abdomen in the erect position, which showed marked gastric distension, but no fluid levels, so I asked for CT abdomen with oral and IV contrast.

CT revealed:

Dilated stomach and duodenum down to the third part, which was relatively reduced in calibre in the aorto-mesenteric component with narrowing. There is distal abrupt changes in the calibre of the small intestinal loops. The angle between the aorta and the superior mesenteric artery was less than 20°.

How to manage this case?

The case was diagnosed as "Superior Mesenteric Artery Syndrome"

You can know all about the syndrome at the articles section.

Last Updated on Friday, 02 November 2018 08:53

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كيف تصل الينا

  • عنوان: 98 شارع التحرير , ميدان الدقي, القاهرة , مصر
     
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حقوق الملكية

 المعلومات الواردة في مختلف صفحات موقع د.سامح لبيب على الإنترنت هي معلومات صادرة عنه لأغراض تعليمية-خدميه. وتلك المعلومات محمية بموجب قوانين  حماية المصنفات الأدبية والفنية واتفاقيات دولية أخرى وبمقتضى القوانين الوطنية الخاصة بحقوق التأليف والحقوق المرتبطة بها. ويجوز استعراض أجزاء من المعلومات الواردة في الموقع أو نسخها أو ترجمتها لأغراض البحث أو لإجراء دراسة شخصية ولكن ليس لبيعها أو استخدامها لأغراض تجارية.

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