Superior mesenteric artery syndrome – A rare presentation and challenge in spinal cord injury rehabilitation: A case report and literature review

Superior mesenteric artery (SMA) syndrome is a rare condition causing obstruction of the duodenum, often due to rapid weight loss. This is especially relevant in spinal cord injury (SCI) rehabilitation where patients may experience rapid weight loss. The article presents two cases of SMA syndrome in SCI patients. The patients experienced different symptoms. One had repeated autonomic dysreflexia and spasticity, while the other experienced nausea, abdominal discomfort, and vomiting. CT scans confirmed duodenal obstruction caused by a narrow angle of the SMA. Both patients improved with nutritional management, avoiding surgery. This highlights the importance of considering SMA syndrome in SCI patients with rapid weight loss and emphasizes the role of early diagnosis through CT scans and nutritional support.

• 1
  SMA syndrome can present with non-specific symptoms like refractory autonomic dysreflexia and worsening spasticity in SCI patients, which can delay diagnosis.
• 2
  CT abdomen with contrast is a valuable tool for early diagnosis, revealing compression of the duodenum, dilation of the left renal vein, and distension of the stomach.
• 3
  Aggressive nutritional management, including nasojejunal tube feeding or total parenteral nutrition, can successfully treat SMA syndrome in SCI patients, often avoiding the need for surgery.