ABSTRACT
Wilkie's syndrome, also known as Superior mesenteric artery (SMA) syndrome, is characterized by intestinal obstruction due to aortomesenteric duodenal compression caused by the reduction of the normal angle between (38-65º) to <25º or to a distance <8mm. The clinical presentation is usually non-specific (dyspepsia, postprandial abdominal pain) but sometimes presented as an acute intestinal obstruction syndrome (nausea, vomiting, gastric dilatation and abdominal distention). In this study, we report the case of a 22-year-old patient with a BMI of 16.5 who presented to the emergency room with acute intestinal obstruction caused by SAMS. He presented with massive gastric dilation that caused ischaemic necrosis of the gastric mucosa with subsequent perforation. It should be noted that only one case associated with Wilkie syndrome has been described in the literature. Therefore, given the rare incidence of complications associated with this syndrome and the favourable prognosis with conservative management, surgery is usually the last line of treatment. However, we must not forget that when necrosis appears, it is often extensive and requires urgent surgical treatment in most cases.
ABSTRACT
Melanoma is a cancer that frequently metastasises to the small bowel, but most cases are asymptomatic and are diagnosed postmortem. Therefore, CT and PET CT cannot detect all lesions and conventional endoscopic study only detects 10-20% of lesions. In this study, we present the case of a 68-year-old patient with a history of cutaneous melanoma and a diagnosis of intestinal melanoma. Thanks to capsule endoscopy, two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected, allowing a much more effective surgical planning. Capsule endoscopy is an innovative technique that improves preoperative diagnosis, as it is able to detect bowel segments that cannot be inspected by conventional endoscopy. It also has a better resolution than conventional CT, improving sensitivity in the detection of lesions.