SHM Converge Scientific Abstract ePoster Gallery-Superior Mesenteric Artery Syndrome in Malignancy: Enteral Feeding May Improve Quality of Life

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Superior mesenteric artery (SMA) syndrome is a rare but important cause of nausea, vomiting, abdominal pain, and reduced oral intake. It occurs when loss of mesenteric fat narrows the angle and distance between the SMA and aorta, compressing the third portion of the duodenum and causing upstream dilation. Because symptoms are nonspecific, diagnosis is often delayed, especially in patients with malignancy, where weight loss and poor intake may be incorrectly attributed to cancer or treatment.<br /><br />This case describes a 75-year-old man with metastatic prostate cancer on triple therapy who developed nausea, decreased oral intake, intermittent abdominal pain, and significant weight loss after chemotherapy. CT imaging showed duodenal dilation and a reduced aortomesenteric distance, confirming SMA syndrome. He could not tolerate nasogastric decompression, so a gastrojejunostomy tube was placed for enteral feeding. He tolerated nutrition support, avoided refeeding syndrome, and was discharged with improved intake. Over time, he regained weight, had his GJ tube removed, and continued tolerating oral intake without abdominal pain.<br /><br />The report emphasizes that SMA syndrome should be considered in patients with malignancy who have persistent gastrointestinal symptoms and weight loss. Early imaging, prompt diagnosis, correction of volume or electrolyte abnormalities, and nutritional support are key. Non-operative management may be sufficient in many cases and can improve quality of life, while surgery is rarely needed if supportive treatment is effective.

Asset Subtitle

Thomas Mologne

Meta Tag

Author List Sarah Jones, Thomas Mologne

Category Clinical Vignettes

Concept Superior Mesenteric Artery Syndrome

Concept Computed Tomography

Concept Aortomesenteric Angle

Concept Aortomesenteric Distance

Concept Nutritional Support

Distinguished Non-Finalist

Presenter Organization University of Pittsburgh School of Medicine

Presenting Author Thomas Mologne

Track Adult

Keywords

Superior mesenteric artery syndrome

SMA syndrome

duodenal compression

aortomesenteric distance

weight loss

nausea and vomiting

abdominal pain

metastatic prostate cancer

enteral feeding

gastrojejunostomy tube

Superior Mesenteric Artery Syndrome

Computed Tomography

Aortomesenteric Angle

Aortomesenteric Distance

Nutritional Support