Presentation
The patient previously well, presents with nausea and vomiting.
Patient Data
Stomach is grossly dilated with nutcracker appearance. Dilatation of proximal duodenum with compression at the angle between aorta and superior mesenteric artery. Angle less than 10°.
Incidental finding of multiple small cortical cysts in the upper and midpole of right kidney, consistent with Bosniak type I cysts.
Case Discussion
Wilkie syndrome is a rare vascular disease, characterized by a decrease in the angle between the superior mesenteric artery and the aorta of less than 22 degrees. This decrease results in compression of structures found at this angle such as the 3rd part of the duodenum and left renal vein.
The most common cause is rapid weight loss, leading to a decreased amount of perivascular fat between the SMA and aorta.
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