Superior mesenleric artery syndrome in type 1 diabetes masquerading as gastroparesis

Abstract

OBJECTIVE - To describe and discuss a case of superior mesenteric artery syndrome (SMAS) presenting with gastrointestinal signs and symptoms mistakenly attributed to, and treated as, diabetic gastroparesis. RESEARCH DESIGN AND METHODS- A case report was compiled describing the clinical presentation, including history and physical examination, evaluation, diagnosis, and treatment of a patient with type 1 diabetes presenting with gastrointestinal complications. RESULTS - Clinical suspicion combined with the appropriate radiological evaluation led to a diagnosis of SMAS, with classic findings of reduced aortomesenteric angle and distance. Surgical intervention resulted in resolution of symptoms and recovery of glycemic control. CONCLUSIONS - The possibility of SMAS should be considered in patients with type 1 diabetes presenting with gastrointestinal symptomatology, especially when associated with weight loss. © 2008 by the American Diabetes Association.