Abstract

Superior mesenteric artery (SMA) syndrome is a rare cause of high section intestinal obstruction. SMA syndrome is characterized by compression of the 3^rd duodenum segment due to a narrowing of the distance between the SMA and abdominal aorta. The main clinical signs of SMA syndrome are high intestinal obstruction, such as postprandial vomiting, epigastric pain, early abdominal fullness, and indigestion. Abdominal computed tomography plays an important role in diagnosis. There are two main methods of treating SMA syndrome: conservative and surgical treatment. We report a clinical case of a 18-year-old male patient admitted to the hospital because of a Bungarus bite in the second hour. On the 12^th day of treatment, the patient developed diarrhea that lasted until the 24^th day of treatment. On the 25^th day of treatment, the patient lost 16 kg (from 56 down to 40). The patient had symptoms of vomiting after eating, indigestion, and epigastric pain. On abdominal computed tomography, the angle created by the SMA and the abdominal aorta was 17 degrees, and the distance between the two arteries was 3.8 m. Light dilation and stagnation of the D1 and D2 segments of the duodenum with gas and watery levels inside segments D3 and D4 of the duodenum were observed, and this segment was constricted. This patient was diagnosed with SMA syndrome due to Bungarus snake bites. Currently, the patients are treated with intravenous feeding through a jejunal tube to each other. Finally, the patient was discharged and returned to his home on the 45^th day of treatment. We reported this clinical case to introduce the clinical and paraclinical signs, diagnoses, and treatment methods for Patients with SMA syndrome.