Superior mesenteric artery syndrome misdiagnosed as acute gastric dilatation

Abstract

Acute gastric dilatation is commonly due to abdominal surgery, anorexia and bulimia nervosa, psychogenic polyphagia, trauma, diabetes mellitus, pneumonia, staphylococci. It is very rarely associated with typhoid or superior mesenteric artery syndrome and much rarely associated with both. A young thin female had been operated for signs of sub-acute intestinal obstruction and found to have very hugely dilated stomach reaching up to the pelvis along with dilated 1st and 2nd part of duodenum. But lumen was patent and no sign of obstruction was found. Later, she found to be typhoid positive. But she did not improved. CT scan revealed signs of superior mesenteric artery syndrome. Division of ligament of trietz with duodenojejunostomy done, after which she improved. It is be concluded that superior mesenteric artery compression may present as acute gastric dilatation. Typhoid may be associated with superior mesenteric artery syndrome.