Emergency department presentation of superior mesenteric artery syndrome: Two cases in Marine Corps recruits

Background: Superior mesenteric artery (SMA) syndrome is a relatively rare etiology of proximal intestinal obstruction. Obstruction results from marked narrowing of the angle between the SMA and aorta, causing compression of the third portion of the duodenum, most commonly as a result of precipitous weight loss. Intermittent non-specific symptoms at presentation often result in a delayed diagnosis, thus the importance of being aware of this condition. Objective: To familiarize emergency physicians with the presentation of SMA syndrome and discuss its diagnosis and management in the emergency department (ED). Case Report: We present two cases of SMA syndrome identified in Marine Corps recruits presenting to our ED. Conclusion: Emergency physicians should include SMA syndrome in the differential diagnosis of abdominal pain and vomiting in individuals with predisposing factors.