Rapport de causalité entre le syndrome de la pince aorto-mésentérique et l’anorexie mentale. À propos d’un cas

Abstract

IntroductionThe mesenteric artery syndrome (MSA) is a rare diagnosis. It is defined by the compression of the third portion of the duodenum between the superior mesenteric artery and aorta. Anorexia is an eventual aetiology among several others. The clinical symptoms of MSA and anorexia may be confused. In fact, the anorexia may be responsible for a MSA and the MSA with post-prandial abdominal pain, early satiety and bilious vomiting may be responsible for a loss of weight. ObservationWe report the case of a 29-year-old patient with an antecedent of a surgical treatment for a MSA who still presents a loss of weight and vomiting. An analysis of her clinical presentation reveals that she already presented signs of anorexia before the diagnosis of MSA. Physical and mental examination shows a patient with a BMI at 15, self-scrutiny, perfectionism, denial and food exclusion. It seems to us that this patient already presented anorexia and a nutritional treatment might have avoided the surgery. Now, we leaded her toward a psychotherapy. ConclusionThe mesenteric artery syndrome must be known by the healthcare professionals so as to avoid unnecessary surgical treatment.