Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome
Background. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction leading to acute kidney injury (AKI). Methods. We report a case of 23-year-old army personnel who presented with persistent vomiting leading to severe hypokalaemia, metabolic alkalosis, and ac...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2020/8364176 |
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| author | Nur Ezzaty Mohammad Kazmin Lydia Kamaruzaman Zhiqin Wong Voon Ken Fong Rozita Mohd Ruslinda Mustafar |
| author_facet | Nur Ezzaty Mohammad Kazmin Lydia Kamaruzaman Zhiqin Wong Voon Ken Fong Rozita Mohd Ruslinda Mustafar |
| author_sort | Nur Ezzaty Mohammad Kazmin |
| collection | DOAJ |
| description | Background. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction leading to acute kidney injury (AKI). Methods. We report a case of 23-year-old army personnel who presented with persistent vomiting leading to severe hypokalaemia, metabolic alkalosis, and acute kidney injury resulting in cardiorespiratory arrest. Results. After successful resuscitation, he was supported with haemodialysis and aggressive electrolytes correction. He was repeatedly not able to tolerate nasogastric (NG) tube feeding and computerised tomography of abdomen was performed, and the diagnosis of SMA syndrome was made. Gastroscopy examination revealed duodenal ulcer at D1, pinhole D1-D2 junction, but there was no evidence of intraluminal mass or lesions leading to upper gastrointestinal obstruction. A nasojejunal tube was inserted to bypass the narrow segment of the duodenum, and he was put on nutritional support. He was subsequently weaned off dialysis support as his renal function gradually improved and later on normalised. He remains symptoms free, and he gained five kilograms in four months after discharge. Conclusions. SMA syndrome is a rare cause of upper gastrointestinal obstruction but should be considered as a differential diagnosis in a patient who presented with recurrent vomiting and AKI with metabolic alkalosis. |
| format | Article |
| id | doaj-art-7cfd83d7677047709c5e2be99741b7f9 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-7cfd83d7677047709c5e2be99741b7f92025-02-03T05:51:45ZengWileyCase Reports in Nephrology2090-66412090-665X2020-01-01202010.1155/2020/83641768364176Acute Kidney Injury Caused by Superior Mesenteric Artery SyndromeNur Ezzaty Mohammad Kazmin0Lydia Kamaruzaman1Zhiqin Wong2Voon Ken Fong3Rozita Mohd4Ruslinda Mustafar5Medical Department, National University of Malaysia Medical Centre, Kuala Lumpur, MalaysiaNephrology Unit, Medical Department, National University of Malaysia Medical Centre, Kuala Lumpur, MalaysiaGastroenterology Unit, Medical Department, National University of Malaysia Medical Centre, Kuala Lumpur, MalaysiaNephrology Unit, Medical Department, National University of Malaysia Medical Centre, Kuala Lumpur, MalaysiaNephrology Unit, Medical Department, National University of Malaysia Medical Centre, Kuala Lumpur, MalaysiaNephrology Unit, Medical Department, National University of Malaysia Medical Centre, Kuala Lumpur, MalaysiaBackground. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction leading to acute kidney injury (AKI). Methods. We report a case of 23-year-old army personnel who presented with persistent vomiting leading to severe hypokalaemia, metabolic alkalosis, and acute kidney injury resulting in cardiorespiratory arrest. Results. After successful resuscitation, he was supported with haemodialysis and aggressive electrolytes correction. He was repeatedly not able to tolerate nasogastric (NG) tube feeding and computerised tomography of abdomen was performed, and the diagnosis of SMA syndrome was made. Gastroscopy examination revealed duodenal ulcer at D1, pinhole D1-D2 junction, but there was no evidence of intraluminal mass or lesions leading to upper gastrointestinal obstruction. A nasojejunal tube was inserted to bypass the narrow segment of the duodenum, and he was put on nutritional support. He was subsequently weaned off dialysis support as his renal function gradually improved and later on normalised. He remains symptoms free, and he gained five kilograms in four months after discharge. Conclusions. SMA syndrome is a rare cause of upper gastrointestinal obstruction but should be considered as a differential diagnosis in a patient who presented with recurrent vomiting and AKI with metabolic alkalosis.http://dx.doi.org/10.1155/2020/8364176 |
| spellingShingle | Nur Ezzaty Mohammad Kazmin Lydia Kamaruzaman Zhiqin Wong Voon Ken Fong Rozita Mohd Ruslinda Mustafar Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome Case Reports in Nephrology |
| title | Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome |
| title_full | Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome |
| title_fullStr | Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome |
| title_full_unstemmed | Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome |
| title_short | Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome |
| title_sort | acute kidney injury caused by superior mesenteric artery syndrome |
| url | http://dx.doi.org/10.1155/2020/8364176 |
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