Clinical Insights into Superior Mesenteric Artery Syndrome with Multiple Diseases: A Case Report

  • Tao Wang
  • Zhi-xin Wang
  • Hai-jiu WangEmail author
Case Report


Superior mesenteric artery (SMA) syndrome is a rare disease caused by compression of the horizontal portion of the duodenum between the aorta and SMA. Clinical manifestations include recurrent episodes of postprandial nausea, vomiting, abdominal pain, and abdominal distention. Nutcracker syndrome (NCS) is a clinical syndrome caused by compression of the renal vein in the left branch of the inferior vena cava; it can be divided into pre-aortic compression and post-aortic compression based on the location of the compression. This symptom is primarily accompanied with hematuria, low back pain, pelvic pain, and gonadal varicose veins (varicocele or ovarian varices). Pancreatitis and gallbladder distention are common, including multi-related biliary stones and biliary tract abnormalities. Here, we describe a rare case of a combination of these multiple diseases.

Case Presentation

A 19-year-old female student, who was a member of the campus track and field team, suffered from...


Superior mesenteric artery syndrome Renal nutcracker syndrome Gallbladder distention Pancreatitis 



This study was financially supported by the key project grant from the Science and Technology Department of Qing Hai Province, China. No. 2016-SF-A5.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare, and they did not use any outside assistance in preparing the manuscript.


  1. 1.
    Gebhart T. Superior mesenteric artery syndrome. Gastroenterol Nurs. 2015;38:189–193.CrossRefGoogle Scholar
  2. 2.
    Nunn R, Henry J, Slesser AA, Fernando R, Behar N. A model example: coexisting superior mesenteric artery syndrome and the nutcracker phenomenon. Case Rep Surg. 2015;2015:649469.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Vulliamy P, Hariharan V, Gutmann J, Mukherjee D. Superior mesenteric artery syndrome and the ‘nutcracker phenomenon’. BMJ Case Rep. 2013. Scholar
  4. 4.
    Gwee K, Teh A, Huang C. Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa. Australas Psychiatry. 2010;18:523–526.CrossRefGoogle Scholar
  5. 5.
    Keane FB, Fennell JS, Tomkin GH. Acute pancreatitis, acute gastric dilation and duodenal ileus following refeeding in anorexia nervosa. Iran J Med Sci. 1978;147:191–192.CrossRefGoogle Scholar
  6. 6.
    Ananthan K, Onida S, Davies AH. Nutcracker syndrome: an update on current diagnostic criteria and management guidelines. Eur J Vasc Endovasc Surg. 2017;53:886–894.CrossRefGoogle Scholar
  7. 7.
    Opie EL. The etiology of acute hemorrhagic pancreatitis. Bull Johns Hopkins Hosp. 1901;12:484–787.Google Scholar
  8. 8.
    Armstrong CP, Taylor TV. Pancreatic-duct reflux and acute gallstone pancreatitis. Ann Surg. 1986;204:59–64.CrossRefGoogle Scholar
  9. 9.
    Howell CW, Bergh GS. Pancreatic duct filling during cholangiography: its effect upon serum amylase levels. Gastroenterology. 1950;6:309–316.Google Scholar
  10. 10.
    Anderson MC, Hauman RL, Suriyapa C, Schiller WR. Pancreatic enzyme levels in bile of patients with extrahepatic biliary tract disease. Am J Surg. 1979;137:301–306.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Hepatopancreatobiliary SurgeryAffiliated Hospital of Qinghai UniversityXiningChina

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