A rare cause of high intestinal obstruction: Wilkie’s syndrome associated with a suprarenal abdominal aortic aneurysm

Wilkie's syndrome, or superior mesenteric artery (SMA) syndrome, is a rare cause of duodenal obstruction due to extrinsic compression between the SMA and the abdominal aorta. We report the unusual case of a 45-year-old patient presenting with Wilkie's syndrome associated with a suprarenal abdominal aortic aneurysm (AAA). The diagnosis was confirmed by an abdominal CT angiography, revealing a fusiform AAA of the suprarenal abdominal aorta, associated with a marked reduction in the aorto-mesenteric angle and compression of the third portion of the duodenum. A multidisciplinary approach was implemented, including initial conservative management with nasogastric decompression, followed by endovascular repair of the aneurysm. The postoperative course was favorable, with no complications. This case highlights a rare etiology and emphasizes the importance of precise diagnosis and a coordinated therapeutic approach, preventing severe complications.