伊東 友弘, 高橋 正一郎, 小川 正純, 倉林 幹雄

Tomohiro ITOH, Seiichiro TAKAHASHI, Masazumi OGAWA, Mikio KURABAYASHI

富士吉田市立病院内科

Department of Internal Medicine, Fujiyoshida Municipal Hospital

キーワード : SMA syndrome, Ultrasonography, Acute duodenal ileus

A 87-year-old man was admitted to this institution complaining of nausea and vomiting. As soon as he was placed on nasogastric tube drainage, a large quantity of bile-containing gastric juice was drained, and the symptoms improved. Oblique obstruction in the third portion of the duodenum was seen with the introduction of barium into the small-intestinal tract. When the symptoms recurred, abdominal ultrasonography showed dilatation of the stomach and proximal duodenum, as well as obstruction of the third portion of the duodenum, between the abdominal aorta and superior mesenteric artery (SMA), leading to a diagnosis of SMA syndrome. Observation by radiologic examination is important in the diagnosis of SMA syndrome, even though it can not show the anatomical relationship between the duodenum and the vertebrae. Abdominal ultrasonography can, however, show the anatomic relationship among the duodenum, abdominal aorta, SMA, stomach and vertebrae in the same image. Abdominal ultrasonography may thus be useful for diagnosing SMA syndrome.