Intestinal obstruction associated with middle aortic syndrome: A case report

This article reports the case of a male patient in his 70s with middle aortic syndrome (MAS). The patient was admitted with abdominal pain, abdominal distension, vomiting, and cessation of defecation for 2 days as chief complaints and was diagnosed with intestinal obstruction. Enhanced computed tomography and vascular reconstruction revealed distal occlusion of the abdominal aorta. The celiac trunk, superior mesenteric artery, and inferior mesenteric artery were not visualized, whereas bilateral renal arteries maintained blood flow. Given the patient's history of intermittent claudication and uncontrolled hypertension, the condition was ultimately diagnosed as MAS secondary to Takayasu's arteritis, with bowel obstruction identified as a secondary manifestation of MAS. After insertion of a nasointestinal obstruction catheter, the patient's symptoms of intestinal obstruction were relieved. However, the obstruction recurred, and the patient subsequently improved following vascular reconstruction. During postoperative follow-up to date, intestinal obstruction has recurred only once due to improper diet and resolved after dietary modifications. MAS is relatively rare in clinical practice, particularly among older patients. We hope that this case study provides clinicians with an opportunity for learning and knowledge exchange, thereby contributing to improved diagnostic and therapeutic approaches for patients with similar conditions.