Superior mesenteric artery syndrome and right paraduodenal hernia causing intestinal obstruction during pregnancy: A case report

Table 1 Reported cases of superior mesenteric artery syndrome in association with pregnancy: Clinical presentation, management, and reported outcomes

Ref.	Maternal characteristics	Pregnancy context	Gestational age	Predisposing factors	Diagnosis and intervention	Outcomes
Iko et al[4], 1986	28 years; history of four pregnancy losses	Recurrent severe gastrointestinal symptoms during multiple pregnancies	24 weeks	Long-standing gastrointestinal symptoms	Upper gastrointestinal barium study; postpartum surgical transposition of the third and fourth portions of the duodenum anterior to the superior mesenteric artery	Maternal: Complete symptom resolution after surgery; fetal: Two subsequent term deliveries following surgical correction
Hillyard et al[13], 2019	38 years; parity not reported	Pre-existing SMA syndrome diagnosed prior to pregnancy; pregnancy occurred during preoperative evaluation	Not reported	Recent intentional weight loss	CT and upper gastrointestinal series; conservative management with oral liquid nutritional support	Maternal: Complete symptom resolution postpartum; fetal: Term delivery
Our study	21 years; first pregnancy	De novo presentation during pregnancy	18 weeks	Rapid weight loss during pregnancy; right paraduodenal hernia	Non-contrast abdominal CT (suggestive); definitive intraoperative diagnosis; antepartum surgical management including reduction of paraduodenal hernia and side-to-side duodeno-duodenostomy	Maternal: Complete recovery with preserved gastrointestinal continuity; fetal: Ongoing viable pregnancy

SMA: Superior mesenteric artery; CT: Computed tomography.