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Radiological Case of the Month

James H. McClenathan, MD; Beverly P. Wood, MD
Am J Dis Child. 1988;142(6):685-686. doi:10.1001/archpedi.1988.02150060119046.
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A 10-year-old girl was admitted for evaluation of an 8.1-kg weight loss. Two weeks before admission, she had an episode of "stomach flu" with fever, epigastric pain, nausea, and vomiting. These symptoms improved temporarily, but several days later abdominal pain and vomiting recurred, with no loss of appetite. Daily abdominal pain was relieved by vomiting. The emesis was bilious and contained undigested food.

At physical examination, she weighed 27.9 kg and appeared emaciated; a soft murmur was heard on the left side of her neck. She was slightly exophthalmic. Thyroid function tests and an upper gastrointestinal tract series were performed (Figure).

Denouement and Discussion 

Hyperthyroidism as a Cause of Superior Mesenteric Artery Syndrome  Upper gastrointestinal tract series shows dilatated duodenum with lack of barium passage beyond third portion of duodenum.The upper gastrointestinal tract series showed normal stomach, pylorus, and duodenal bulb. The second and third portions of the


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