Recurrent Small Bowel Obstruction in an Adolescent Patient

A 14-year-old adolescent boy with a body mass index of 14.0 kg/m2was admitted to the emergency department with a 1-year medical history of recurrent epigastric pain associated with bilious vomiting. All episodes spontaneously resolved in 8–12 hours from onset. An abdominal computed tomography (CT) scan with intravenous contrast was performed during an acute episode. The CT scan was suggestive for superior mesenteric artery syndrome (SMAS). The first therapeutic approach is aimed at restoring ideal body weight. Our patient’s clinical manifestation progressively resolved after weight gain, and he was free from all symptoms 1 year after the diagnosis. The surgical option with duodenal bypass should only be considered when conservative treatment fails.