Superior Mespitarian Artery Syndrome in Patient with Snake Bites

Abstract

Superior mesenteric artery (SMA) syndrome is a rare cause of high section intestinal obstruction. SMA is characterized by compression of the third segment of the duodenum due to narrowing of the distance between the superior mesenteric artery and the abdominal aorta. The main clinical signs of SMA are high intestinal obstruction: postprandial vomiting, epigastric pain, early feeling of fullness, and indigestion. Abdominal computed tomography plays an important role in diagnosis. There are two main methods of treating SMA: Conservative and Surgical. We report a clinical case of an 18-year-old male patient admitted to the hospital because of a Bungarus snake bite in the 2nd hour, the 12th day of treatment, the patient developed diarrhea that lasted until the 24th day of treatment. On the 25th day of treatment, The patient lost 16kg (from 56kg down to 40kg), had symptoms of vomiting after eating, indigestion, and epigastric pain. On computed tomography, the angle created by the superior mesenteric artery and the abdominal aorta is 17 degrees, the distance between the two arteries is 3.8 mm; Slight dilation and stagnation of the D1 and D2 duodenum, with a slightly watery level inside; segments D3 and D4 collapse. Diagnosed as superior mesenteric artery syndrome in a patient with a Bengarus snake bites. Currently, the patient is being treated with feeding through a jejunal tube combined with partial intravenous nutrition. This report aims to introduce the clinical case of SMA, clinical and paraclinical signs, and methods SMA treatment.