Comprehensive interventions for adult cyclic vomiting syndrome complicated by superior mesenteric artery syndrome: A case report
BACKGROUND Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea, vomiting, abdominal pain, and interspersed complete normal periods. Superior mesenteric artery (SMA) syndrome (SMAS)...
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| Published in | World journal of clinical cases Vol. 12; no. 29; pp. 6327 - 6334 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Baishideng Publishing Group Inc
16.10.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2307-8960 2307-8960 |
| DOI | 10.12998/wjcc.v12.i29.6327 |
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| Summary: | BACKGROUND
Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea, vomiting, abdominal pain, and interspersed complete normal periods. Superior mesenteric artery (SMA) syndrome (SMAS) is a vascular condition in which the horizontal portion of the duodenum is compressed due to a reduced angle between the aorta and the SMA. This condition presents with symptoms similar to CVS, posing challenges in distinguishing between the two and often resulting in misdiagnosis or inappropriate treatment.
CASE SUMMARY
A 20-year-old female patient presented with recurrent episodes of vomiting and experienced a persistent fear of vomiting for the past 2 years. She adopted conscious dietary restrictions, which led to severe malnutrition. Initially, she was diagnosed with SMAS, as revealed by computed tomography angiography. Despite efforts to increase the angle between the aorta and the SMA through weight gain, her vomiting did not improve. Finally, she was diagnosed with comorbidities including CVS, SMAS and anxiety disorder. She underwent comprehensive interventions, including enteral and parenteral nutritional supplementation, administration of antiemetic and anti-anxiety agents, and participation in mindfulness-based cognitive therapy. The patient eventually experienced a notable improvement in both body weight and clinical symptoms.
CONCLUSION
We present a rare case of CVS in an adult complicated with SMAS and propose additional treatment with nutritional support, pharmacological intervention, and psychotherapy. |
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| Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 Corresponding author: Wei Zhang, Doctor, MD, Chief Doctor, Professor, Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu 610041, Sichuan Province, China. weizhanghx@163.com Author contributions: Liu B wrote original manuscript; Sun H performed imaging examination; Liu Y, Yuan ML and Zhu HR revised the manuscript; Zhang W designed the study; all authors have read and approved the final manuscript. Liu B and Sun H contributed equally to this work as co-first authors. The designation of co-first authorship for Liu B and Sun H is based on the following reasons. Firstly, the research was conducted as a collaborative effort, with the distribution of responsibilities and efforts evenly shared between the two, accurately reflecting their equal contribution to the study and the resultant paper. Secondly, the study involved multidisciplinary cooperation, particularly in the fields of psychiatry and radiology. Liu B served as the psychiatrist responsible for addressing clinical data, while Sun H acted as the radiologist responsible for analyzing image data. Therefore, we believe that designating Liu B and Sun H as co-first authors appropriately represents our team's collaborative spirit, equal contributions, and the interdisciplinary nature of our work. Co-first authors: Bo Liu and Hui Sun. Supported by 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, No. ZYJC21004. |
| ISSN: | 2307-8960 2307-8960 |
| DOI: | 10.12998/wjcc.v12.i29.6327 |