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Superior mesenteric artery syndrome masquerading as recurrent biliary pancreatitis.

• Vol 8 • June 2006 SMA Syndrome Masquerading as Pancreatitis The superior mesenteric artery syndrome (also known as Wilkie’s syndrome) is a rare entity with various manifestations. The syndrome usually affects young adults. It is commonly described as a complication of spinal procedures or after significant weight loss. It is caused by obstruction of the post-papillary duodenum by an acute angle between the SMA and the aorta. It usually presents as crampy upper abdominal pain, relieved by vomiting or crouching. It may mimic pancreatitis due to the location and nature of the pain and an elevation in blood amylase [1-3]. We present a 16 year old boy with cerebral palsy and hydrocephalus who was misdiagnosed as suffering from recurrent bouts of biliary pancreatitis for 2 years. A cholecystectomy, laparotomy and endoscopic retrograde cholangiopancreatography were performed before the correct diagnosis was established, and he was successfully treated conservatively.