| Summary: | Introduction: Superior mesenteric artery (SMA) syndrome is described as compression of the third part of the duodenum between SMA and aorta with resultant obstruction and dilatation of proximal duodenum and stomach. Virtually, any condition associated with weight reduction may predispose the patient to SMA syndrome. Case presentation: A 17-year-old boy complaining from persistent vomiting, dull abdominal pain, anorexia, and weight loss for long time presented to the pediatric surgery department. Computed tomography (CT) of the abdomen was prescribed to look for the cause of persistent vomiting and bulging of the epigastrium. Contrast Enhanced CT revealed decreased aortomesenteric angle and aortomesenteric distance causing compression of third part of duodenum with resultant marked distension of proximal duodenum, stomach, and even esophagus. The patient underwent laparotomic gasterojujenostomy. Conclusion: SMA syndrome is a rare clinical entity. CT can well delineate this abnormality. SMA syndrome can be treated with both conservative and surgical approaches. Keywords: Case report, Superior mesenteric artery syndrome, Vomiting, Upper gastrointestinal tract obstruction, Cachexia
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