A Two-for-One Diagnosis: A Rare Case of Chronic Abdominal Pain Caused by Gastroptosis and Wilkie’s Syndrome in a Young Woman

TL;DR

A young woman experienced chronic abdominal pain due to two rare conditions, gastroptosis and Wilkie’s syndrome, which had not been previously reported together.

Contribution

This is the first documented case of coexisting gastroptosis and SMA syndrome in a young patient.

Findings

A 17-year-old girl was diagnosed with both gastroptosis and SMA syndrome after six months of postprandial pain and vomiting.

CT and barium radiography confirmed duodenal stricture and severe gastric elongation.

The case highlights the importance of considering rare anatomical causes in diagnosing chronic abdominal pain.

Abstract

Long-term abdominal pain (LAP) affects 30% to 40% of children, often linked to functional gastrointestinal disorders (FGIDs) such as functional dyspepsia and irritable bowel syndrome. Less common causes include gastroptosis and superior mesenteric artery (SMA) syndrome, conditions that can be challenging to diagnose due to their rarity. Gastroptosis refers to the downward displacement of the stomach, while SMA syndrome, also known as Wilkie’s syndrome, involves the compression of the duodenum between the abdominal aorta and the superior mesenteric artery. While both conditions have been described separately, their coexistence has not been previously documented. Herein, we present the case of a 17-year-old girl with a six-month history of postprandial abdominal pain and vomiting, diagnosed with both gastroptosis and SMA syndrome. Diagnostic tests, including a CT scan and barium radiography, confirmed the presence of a duodenal stricture and severe gastric elongation, providing an insight into the pathophysiology of these rare conditions.

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