クローン病と上腸間膜動脈症候群が合併し、神経性食欲不振症との鑑別に苦慮した1例 [in Japanese] A Case of Crohn's Disease Associated with Superior Mesenteric Artery Syndrome Presenting as Anorexia Nervosa [in Japanese]
Access this Article
Search this Article
A case of fourteen-year-old girl with postprandial abdominal pain, nausea and vomiting is presented. Gastroscopy and abdominal ultrasonogram did not reveal any major abnormalities, although the fecal hemoglobin concentration was increased. She was referred to the Dept. of Psychosomatic Medicine because anorexia nervosa was suspected. She was quite emaciated and had not entered menarche, but was without phobia of weight gain or distortion of body image. Low grade fever and tachycardia persisted and blood test showed an inflammtory reaction. Further studies, however, including barium enema and CT of the abdomen were non contributory. Almost one year after the initial consultation, she was hospitalized and superior mesenteric artery syndrome was noted on an upper GI series and abdominal ultrasonogram. As obstruction of duodenum at the superior mesenteric artery was severe, Iaparotomy was performed. At surgery, Iongitudinal ulceration of the terminal ileum was incidentally found. Histological examination confirmed Crohn's disease. Post-operatively, the gastrointestinal symptoms settled, and her weight increased from 23 kg to 42 kg over one and half years and regular menstruation has begun. To our knowledge, there has been no previously reported case of Crohn's disease associated with superior mesenteric artery syndrome, in which the combination presented as anorexia nervosa. This paper emphasizes that each of the disorders should be considered during the differential diagnosis of anorexia nervosa.
- Japanese Journal of Psychosomatic Medicine
Japanese Journal of Psychosomatic Medicine 36(6), 513-517, 1996
Japanese Society of Psychosomatic Medicine