Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa

Eating Disorders Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia.
Australasian Psychiatry (Impact Factor: 0.47). 10/2010; 18(6):523-6. DOI: 10.3109/10398562.2010.498885
Source: PubMed


The aim of this paper is to describe the presentation and clinical management of a patient with anorexia nervosa complicated by superior mesenteric artery syndrome and pancreatitis, and discuss the association between these conditions.
We present a case report and briefly review the relevant literature.
A 17-year-old girl with undiagnosed anorexia nervosa presented acutely with abdominal symptoms and vomiting. After numerous investigations, she was diagnosed with the rare condition of superior mesenteric artery syndrome and pancreatitis, leading to a prolonged hospital admission and management on both an acute medical/surgical ward and an eating disorders unit.
Anorexia nervosa has been associated with superior mesenteric artery syndrome and pancreatitis. Clinical awareness of these conditions can result in prompt diagnosis and optimal management of these patients.

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    • "Gastrointestinal complications in eating disorders are common and include parotid enlargement with hyperamylasemia , dysphagia, gastric dilatation due to delayed gastric emptying, constipation, pancreatic abnormalities [1] and superior mesenteric artery syndrome (SMAS) [3]. However, only two patients who simultaneously suffered from both SMAS and pancreatitis have ever been reported in eating disorders [4] [5]. We describe here a patient with ED-NOS who exhibited both SMAS and pancreatitis concomitantly, the first case report of a patient with these diseases in the pediatric literature. "

    Open Journal of Pediatrics 01/2011; 1(04):94-97. DOI:10.4236/ojped.2011.14022
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    ABSTRACT: Background/Aim: The role of diet as the cause of acute pancreatitis (AP) has been suggested. The aim of the current review was to determine if there exists sufficient evidence linking nutrition, or the lack of it, to the pathogenesis of AP. Patients and Methods: A systematic search of the scientific literature was carried out using Embase, PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials for the years 1965 - 2011 to obtain access to studies involving dietary factors and the pathogenesis of AP. Results: A total of 17 studies were identified describing diet and AP. These included 12 human and 5 animal studies. 8 reports were found to link malnutrition and/or refeeding to the pathogenesis of AP. Two studies found an increased consumption of fats and proteins in patients with alcohol-related AP while 1 study noted a lesser intake of carbohydrate in patients. However, none of these differences attained statistical significance. A recent prospective case-control study found a significantly higher risk for AP amongst patients eating par-boiled rice and fresh water fish. Conclusions: Evidence from literature does not appear to support the role of diet as a single bolus meal as a cause for AP. Prolonged consumption of diets rich in proteins and fats may work synergistically with gallstones / alcohol to trigger an attack of AP indicating a possible role of diet as a cofactor in the development of AP possibly by lowering the threshold needed by these other agents to lead to the attack of AP.
    Saudi Journal of Gastroenterology 03/2012; 18(5):310. DOI:10.4103/1319-3767.101124 · 1.12 Impact Factor
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    ABSTRACT: We report the case of a 19-year-old military trainee that presented to the emergency department with a 3-week history of diffuse abdominal pain, 1 to 2 hours postprandially. The timing, onset, quality, and location of her pain was concerning for intestinal angina. Her serum chemistry, hematology, and liver function tests were normal. The radiologist's interpretation of the computed tomography angiogram of the abdomen was an abnormally narrow takeoff angle of the superior mesenteric artery (SMA) from the aorta near the third portion of the duodenum. She was diagnosed with SMA syndrome and received additional evaluation and treatment by her gastroenterologist and surgeon. SMA syndrome is rare and can cause bowel obstruction, perforation, gastric wall pneumatosis, and portal venous gas formation. Computed tomography angiography can be used to promptly diagnose this syndrome in the emergency department.
    Military medicine 03/2013; 178(3):e398-e399. DOI:10.7205/MILMED-D-12-00415 · 0.77 Impact Factor
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