Wilkie's syndrome caused by exogenous hyperthyroidism in a patient with primary autoimmune hypothyroidism: a case report and literature review

• Autores: Cervantes Pérez, Enrique, Martínez-Soto Holguín, Martha C., Diaz Juárez, Juan Pedro, Reyes Ramírez, Ana Luz del C.
• Formato: artículo
• Fecha de Publicación: 2020
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: español
• OAI Identifier: oai:ojs.revistagastroperu.com:article/1129
• Enlace del recurso: http://www.revistagastroperu.com/index.php/rgp/article/view/1129
• Nivel de acceso: acceso abierto
• Materia: Síndrome de Wilkie; Síndrome de la arteria mesentérica superior; Obstrucción intestinal; Terapia nutricional

Wilkie's syndrome or superior mesenteric artery syndrome is an unusual cause of proximal intestinal obstruction, primarily attributed to recent weight loss. We report the case of a 19-year-old woman comes to our clinic and reports weight loss, abdominal pain, nausea, and vomiting. Laboratory tests revealed anemia, hypoalbuminemia, hypomagnesemia, and asuppressed thyroid stimulating hormone secondary to levothyroxine. A barium swallow test showed gastric dilatation, delayed gastric emptying and an axial computed tomography revealed an aortomesenteric angle of 11.7°. Conservative management with total parenteral and enteral nutrition was initiated, being the first-line treatment. In refractory cases surgery is a safe and effective option.