Introduction:

Superior Mesenteric Artery Syndrome (SMAS) is a rare vascular-origin intestinal obstruction affecting the third portion of the duodenum. It is often underdiagnosed due to its multiple confounding factors, leading to delays in diagnosis and a high morbidity and mortality rate. The primary underlying mechanism is significant weight loss, and it is more commonly seen in young women. Current treatment approaches include either medical management or minimally invasive surgery.

Case Presentation:

We present the case of a 61-year-old woman with a six-month history of insidious abdominal pain and recurrent episodes of vomiting, accompanied by severe weight loss. Imaging studies confirmed a diagnosis of SMAS, which was secondary to tumor recurrence in metastatic breast cancer. Conservative management was initiated; however, the patient ultimately succumbed to infectious complications.

Conclusions:

SMAS is a rare and challenging condition to diagnose. Various underlying factors contribute to significant weight loss, which is central to its pathophysiology. Computed tomography (CT) and magnetic resonance imaging (MRI) are the preferred diagnostic modalities. While conservative management remains the first-line treatment, it is associated with a high recurrence rate. Surgical intervention, though an option, carries substantial morbidity risks due to the complexity of the procedure.

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