Superior mesenteric artery syndrome (SMAS) is an uncommon condition, attributable to vascular compression of the third part of the duodenum between the superior mesenteric artery and the abdominal aorta. It can present in patients due to mechanical compression or severe
weight loss. We present a unique case of SMAS in a patient undergoing
carboplatin-based
chemotherapy for
mesothelioma. An 81-year-old male with
mesothelioma was treated with
carboplatin-based
chemotherapy. He subsequently suffered a progressive, unintentional 18 kg
weight loss and presented acutely with intense epigastric
pain, severe
nausea, and
vomiting. Diagnosis was confirmed by abdominal computed tomography and esophagogram with upper gastrointestinal series, which revealed gastric and duodenal distention and a narrow angle between the superior mesenteric artery and aorta, causing compression of the duodenum. Prompt recognition of this syndrome allowed us to treat our patient successfully and avoid the risks of operative interventions. To our knowledge, this is the first reported case of SMAS in patients receiving
carboplatin. Furthermore, this case of SMAS was unique in that it was due to
weight loss as compared with mechanical obstruction. Our experience illustrates the importance of considering SMAS in
chemotherapy patients, especially those with substantial
weight loss. A high index of suspicion for this potential complication coupled with appropriate radiographic studies are necessary for early diagnosis and can prevent severe consequences.