A 33-year-old female patient presented to the emergency department for diffuse, progressive abdominal pain, nausea, bile vomiting, loss of appetite, and weight loss of 15 kg in the last three months. The pain was characteristically located in the epigastrium, with diffuse extension in the rest of the abdomen, after food ingestion. The symptoms began in the last year, after the initiation of a planned weight loss diet. Over time, her food tolerance gradually decreased, accentuating the symptoms. She presented multiple times to the emergency department with the same symptoms. At every evaluation, an organic cause was excluded, fluid resuscitation was performed, and a psychogenic origin of the symptoms was suspected, given her past medical history. She was previously diagnosed with Hashimoto thyroiditis and was under levothyroxine replacement therapy at 125 µg/d. After the onset of her symptoms, she was diagnosed with major anxiety-depressive disorder and placed under treatment with alprazolam 0.5 mg, 1 mg/24 h, and escitalopram 10 mg, 25 mg/24 h. The patient had a history of irregular diets, with attempts to lose weight under normal weight conditions. Her history included surgical repair of bilateral inguinal hernia and an episode of acute pancreatitis of unknown cause. Physical examination revealed a cachectic patient with an anxious face and a body mass index (BMI) of 17.8 kg/m² (normal level 18.5-24.9 kg/m²) at 45 kg and 159 cm height, with tenderness in the epigastrium. Laboratory results showed an elevated hemoconcentration [hemoglobin 16.8 g/dL (n.v. 12-15.5 g/dL), hematocrit 48.8% (n.v. 37%-47%)], with hyposodemia [131 mmol/L (n.v. 136-146 mmol/L)], and hypocloremia [91 mmol/L (n.v. 101-109 mmol/L)], which were easily corrected with fluid resuscitation. Upper digestive endoscopy: Given her symptoms in the superior abdomen, upper digestive endoscopy was performed, and esophagitis and gastritis secondary to bile reflux in the gastric antrum were detected. The first and second parts of the duodenum also had acute erosion and flattened folds. Biopsies were performed to exclude celiac disease and confirm chronic duodenitis. Treatment was initiated with proton pump inhibitor 40 mg, 80 mg/24 h, sucralfate 2 tb/12 h, and prokinetic domperidone 10 mg, 30 mg/24 h. Vitamins were prescribed. Angio-computed tomography: After one month, given the persistence of the symptoms, computer tomography angiography (Angio-CT) of the abdomen and pelvis was performed. The results revealed emergence at a sharp angle of 13.7° of the superior mesenteric artery, with a reduced distance between the SMA and the anterior wall of the aorta up to a maximum of 8 mm. In this clinical-biological context, a diagnosis of aortomesenteric clamp was established. A psychiatric consultation was performed, and the diagnosis of major anxiety-depressive disorder was confirmed. Treatment was continued with alprazolam 0.5 mg, 1 mg/24 h and escitalopram 10 mg, 25 mg/24 h, and regular evaluations were scheduled.