Combined superior mesenteric artery syndrome and nutcraker syndrome presenting as acute pancreatitis: a case report
Síndrome da artéria mesentérica superior em combinação com síndrome de quebra-nozes manifestando-se como pancreatite aguda: relato de caso
Bárbara Neto Castro; Ana Rita Ferreira; Susana Graça; Manuel Oliveira
Abstract
Keywords
Resumo
Resumo: A síndrome da artéria mesentérica superior designa compressão da terceira parte do duodeno pela artéria mesentérica superior e a aorta. Essa condição tem uma baixa incidência, sendo mais comum em mulheres jovens magras. A síndrome de quebra-nozes resulta da compressão da veia renal esquerda pela artéria mesentérica superior e a aorta. Ambas as entidades são raras, e a sua coexistência foi descrita em poucos casos. Tratamento conservador com o objetivo de ganho ponderal é suficiente na maioria dos casos. A associação entre a síndrome da artéria mesentérica superior e a pancreatite aguda foi raramente relatada. Pretendemos descrever o caso de uma jovem de 18 anos que recorreu ao serviço de urgência com epigastralgia e vômitos. A investigação realizada revelou pancreatite aguda alitiásica. Durante o estudo complementar, foi identificada a síndrome da artéria mesentérica superior, bem como uma veia renal esquerda comprimida. A paciente encontra-se em tratamento conservador, apresentando melhora clínica.
Palavras-chave
Referências
1 Diab S, Hayek F. Combined superior mesenteric artery syndrome and nutcracker syndrome in a young patient: a case report and review of the literature. Am J Case Rep. 2020;21:e922619.
2 Farina R, Iannace FA, Foti PV, et al. A case of nutcracker syndrome combined with Wilkie syndrome with unusual clinical presentation. Am J Case Rep. 2020;21:e922715.
3 Ruffle JK, Power N, Aziz Q. Abdominal pain presenting as a tight squeeze on a Tchaikovsky score. Gastroenterology. 2019;156(3):e3-5.
4 Berdugo Hurtado F, Díaz Alcázar MM, Torrecillas Cabrera MM, Miras Ventura JA. Aortomesenteric clamp: association with Wilkie syndorme and nutcracker syndrome. Rev Esp Enferm Dig. 2021;113(5):372-4.
5 Oh MJ. Superior mesenteric artery syndrome combined with renal nutcracker syndrome in a young male: a case report. Korean J Gastroenterol. 2017;70(5):253-60.
6 Farina R, Gozzo C, Foti PV, et al. A man with the rare simultaneous combination of three abdominal vascular compression syndromes: median arcuate ligament syndrome, superior mesenteric artery syndrome, and nutcracker syndrome. Radiol Case Rep. 2021;16(6):1264-70.
7 Cienfuegos JA, Vivas Pérez I, Rotellar F. Co-occurrence of compression syndromes: celiac axis stenosis, superior mesenteric artery and nutcracker syndrome. Rev Esp Enferm Dig. 2020;112(11):885.
8 Stubberud A, Cheema S, Tronvik E, Matharu M. Nutcracker syndrome mimicking new daily persistent headache: a case report. Cephalalgia. 2020;40(9):1008-11.
9 Lin TH, Lin CC, Tsai JD. Superior mesenteric artery syndrome and nutcracker syndrome. Pediatr Neonatol. 2020;61(3):351-2.
10 Al-Zoubi NA. Nutcracker syndrome accompanying with superior mesenteric artery syndrome: a case report. Clin Med Insights Case Rep. 2019;12:1179547619855383.
11 Shi Y, Shi G, Li Z, Chen Y, Tang S, Huang W. Superior mesenteric artery syndrome coexists with nutcracker syndrome in a female: a case report. BMC Gastroenterol. 2019;19(1):15.
12 Heidbreder R. Co-occurring superior mesenteric artery syndrome and nutcracker syndrome requiring Roux-en-Y duodenojejunostomy and left renal vein transposition: a case report and review of the literature. J Med Case Rep. 2018;12(1):214.
13 Osegueda de Rodríguez EJ, Hernández-Villegas AC, Serralde-Zúñiga AE, Reyes-Ramírez A. The two sides of superior mesenteric artery syndrome treatment: conservative or surgical management? Nutr Hosp. 2017;34(4):997-1000. PMid:29095027.
14 Michael PG, Al-Saadi T, Jamkhandikar R. A rare case of coexisting superior mesenteric artery syndrome and nutcracker phenomenon. Sultan Qaboos Univ Med J. 2017;17(3):e368-70.
15 Jomni T, Larguech M, Abdelaali I, Charfi M, Dougui MH. Anemia revealing a rare association: superior mesenteric artery syndrome and nutcracker syndrome. Tunis Med. 2016;94(2):162-3. PMid:27532538.
16 Alenezy A, Obaid AD, Qattan AA, Hamad A. Superior mesenteric artery syndrome and nutcracker phenomenon. Saudi J Med Med Sci. 2014;2(3):223-5.
17 Estraviz B, Arévalo JA, Eizaguirre E, et al. Laparoscopic approach for the multiple abdominal vascular entrapment syndrome. Hepatogastroenterology. 2012;59(113):175-7. PMid:22251534.
18 Felton BM, White JM, Racine MA. An uncommon case of abdominal pain: superior mesenteric artery syndrome. West J Emerg Med. 2012;13(6):501-2.
19 Claro M, Sousa D, Silva AA, Grilo J, Martins JA. Wilkie’s syndrome: an unexpected finding. Cureus. 2021;13(12):e20413. PMid:35047254.
20 Waseem M, Upadhyay R, Prosper G. The nutcracker syndrome: an underrecognized cause of hematuria. Eur J Pediatr. 2012;171(8):1269-71.
21 Ammaturo C, Giardiello C, Piscitelli L, Romano C, Pascotto R, Formato M. The superior mesenteric artery syndrome: a rare cause of acute pancreatitis. Panminerva Med. 1988;30(2):114-7. PMid:2459651.
22 Gwee K, Teh A, Huang C. Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa. Australas Psychiatry. 2010;18(6):523-6.
23 Sihuay-Diburga DJ, Accarino-Garaventa A, Vilaseca-Montplet J, Azpiroz-Vidaur F. Acute pancreatitis and superior mesenteric artery syndrome. Rev Esp Enferm Dig. 2013;105(10):626-8.
24 Kojima S, Suzuki K, Katayama N, Imai H. Superior mesenteric artery syndrome as a cause of acute pancreatitis. BMJ Case Rep. 2016;2016:bcr2016217073.
25 Wang T, Wang ZX, Wang HJ. Clinical insights into superior mesenteric artery syndrome with multiple diseases: a case report. Dig Dis Sci. 2019;64(6):1711-4.
Submetido em:
26/12/2022
Aceito em:
10/04/2023
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email