Superior Mesenteric Artery Syndrome: Weight Loss Can Be a Problem, Weight Gain Can Be a Solution

INTRODUCTION: Superior mesenteric artery syndrome (SMAS) is a rare acquired disorder, which in the present case had an acute and unusual way of presentation. CASE REPORT: We present a 17-year-old female with nausea, vomiting, and intense epigastric pain. In the previous 6 months, she had lost 42% of her body weight. The echography showed a distended stomach that reached the pelvis, and the nasogastric tube that was placed drained 2,000 mL. A computed tomography scan confirmed the SMAS diagnosis. She started a hypercaloric fractionated meal diet, prokinetics, and postural measures. After the 1-year follow-up the patient is asymptomatic. CONCLUSION: This acute presentation is rare but life-threatening due to the possibility of gastric rupture. Medical management is possible in the majority of cases, and surgery is needed only in the refractory ones.