Abstract
INTRODUCTION AND IMPORTANCE: Superior mesenteric artery (SMA) syndrome is a rare morbid vascular disorder that is defined as the decrease in the aortomesenteric angle and the compression of the third part of the duodenum. This disorder mainly affects young adult females, and severe weight loss represents a leading predisposing factor. CASE PRESENTATION: The authors report the case of a 19-year-old male who was admitted to our hospital with a 3-month history of epigastric pain, nausea, and weight loss. Two months earlier, the patient was diagnosed with Helicobacter pylori-induced gastritis. Nevertheless, with complaints of severe headache and epigastric pain, the patient was admitted to our hospital for further investigations. Computed tomography (CT) scan with intravenous contrast injection was performed, and interestingly, the aortomesenteric angle was 19° accompanied by a compression of the third part of the duodenum, and a mild gastric dilatation. Accordingly, the diagnosis was confirmed as superior mesenteric artery syndrome. CLINICAL DISCUSSION: In the authors' case, the non-specific clinical symptoms correlated with histopathological examinations led to the initial diagnosis of Helicobacter pylori-induced gastritis. Surprisingly, the lack of improvements led to performing CT scan, which confirmed the diagnosis of SMA syndrome. Subsequently, HP gastritis played a significant role in misleading and delaying the diagnosis. CONCLUSION: The authors report the first case report from Syria of s superior mesenteric artery syndrome that was misdiagnosed and preceded by HP-induced gastritis, highlighting the crucial role of detailed clinical and radiological examinations in the diagnosis of challenging cases with morbid complications.