The 32-year-old lady was complaining over a month about gradual and severe bloating, epigastric pain, left flank ache, nausea and vomiting at occasions. Patient History: Urine stone with 2 weeks of drotaverine hydrochloride treatment before the gastrointestinal symptoms. No significant surgery, but nearly 10 kg rapid weight loss (BMI from 21 kg/m 2 to less than 18 kg/m 2 in two months).
Clinical Features and Diagnosis: Aggravated pain in supine posture and relieved in prone or left lateral decubitus. Early satiety due to blotting and vomiting started 40 min post meal. Abdominal examination- upper abdominal tenderness and distention Urine examination- No significant abnormality Other blood investigations were unremarkable Figure shows CT imaging showing Superior mesenteric artery (SMA or Wilkie’s syndrome or Benign duodenal stasis) syndrome and Nutcracker Syndrome predisposed by…
