ABSTRACT
Superior mesenteric artery (SMA) syndrome is an angulation of SMA causes compression of the duodenum between the SMA and the aorta. The symptoms are not unique and can be seen in several other gastrointestinal pathologies like ileus, gastroesophageal reflux, pancreaitis etc. We report a 25-year-old female who presented with intermittent abdominal pain and intractable vomiting. The patient underwent Nissen-fundoplication, laparotomy, small bowel resection, and bridectomy operations. Also the patient received medical theraphies for pancreatitis, ileus and anorexia. This case emphasizes the challenges in the diagnosis of SMA syndrome and the need for increased awareness of this entity. This will improve early recognition in order to reduce irrelevant tests and unnecessary treatments.