Superior Mesenteric Artery Syndrome in a patient with Mucosal Tissue Associated Lymphoma. Case report

Abstract

Wilkie's syndrome or Superior Mesenteric Artery Syndrome is a rare pathology whose incidence ranges from 0.0024% to 3%, caused by compression of the Superior Mesenteric Artery on the third portion of the duodenum. In general, it is related to weight loss and a decrease in the thickness of the adipose tissue that acts as a support between these anatomical structures. Mucosa-associated marginal zone lymphoma (MALToma) is a rare oncological disease of lymphocytic lineage; usually localized in 90% of cases in the stomach and duodenum, and rarely in the ileum. The coexistence of both pathologies has not been reported. This is a case report of a 31-year-old female patient known to have lymphoma associated with mucous tissue in the terminal ileum, who reported diffuse postprandial abdominal pain, with exacerbation of pain in the left lateral decubitus position and improvement in the genupectoral position. She only reported weight loss of 10 kilograms in 5 months. She underwent a computerized axial tomography with intravenous contrast that showed an aorto-mesenteric angle of 17.4º. It was managed medically, taking into account that in most patients the solution is usually surgical with minimally invasive procedures. The diagnostic process of this patient was the anatomical correlation of the symptoms. Superior mesenteric artery syndrome should be suspected in the presence of abdominal pain of unknown cause.