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제1형 당뇨병 환자에서 상장간막동맥 증후군과 Nutcracker Syndrome이 동반된 1예
김정한 ( Jung Han Kim ),김기태 ( Ki Tai Kim ),변정래 ( Jeong Rae Byun ),김성화 ( Seong Hwa Kim ),허정욱 ( Jeong Uk Heo ),당원광 ( Yuan Kuang Tang ),소유성 ( Yu Cheng Shu ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Superior mesenteric artery (SMA) syndrome is an uncommon cause of a proximal intestinal obstruction. The most characteristic symptoms are postprandial fullness, nausea, and vomiting. The diagnosis is established by ultrasonography and contrast-enhanced computed tomography. Almost all patients respond well to conservative management. However, if conservative management fails, surgical options should be applied. In this article, we report a case of SMA syndrome with Nutcracker syndrome in a patient with diabetes mellitus. Establishing the diagnosis of Nutcracker syndrome is usually based on clinical suspicion and radiological findings. Several complications that have been reported to result from SMA syndrome include peptic ulcer disease, pancreatitis, metabolic alkalosis, and uremic syndrome. However, Nutcracker syndrome accompanied by SMA syndrome is extremely uncommon, as described in this case. To our knowledge, this association has not been reported previously. (Korean J Med 2012;83:613-618)
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