Wilkie’s Syndrome as an Uncommon Cause of Duodenal Obstruction: Case Report

Abstract

Wilkie’s syndrome, also known as superior mesenteric artery syndrome, is a rare clinical entity characterized by compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery, leading to partial or complete duodenal obstruction. Due to its low prevalence and the nonspecific nature of its clinical presentation, diagnosis is often delayed, which can result in nutritional deterioration and the development of complications. We present the case of a young female patient with postprandial abdominal pain, nausea, recurrent vomiting, and significant weight loss, in whom imaging studies confirmed a decreased aortomesenteric angle and duodenal compression consistent with Wilkie’s syndrome. Conservative management was initially attempted, but clinical improvement was not achieved, so surgical treatment via open duodenoduodenostomy was performed. Postoperative evolution was favorable, with resolution of symptoms, adequate oral intake tolerance, and progressive improvement of nutritional status. This case report highlights the importance of considering Wilkie’s syndrome in the differential diagnosis of upper intestinal obstruction, as well as the relevance of timely diagnosis and appropriate therapeutic intervention to improve patient outcomes.